National Provider Identifier
Angela Manjgaladze
Angela Manjgaladze is listed in the NPPES registry with a primary specialty of Psychiatric/Mental Health Nurse Practitioner in Victor, NY and a listed phone number of (585) 337-0992.
Profile Overview
- NPI
- 1194281444
- Provider Type
- Individual
- Primary Specialty
- Psychiatric/Mental Health Nurse Practitioner
- Enumeration Date
- February 12, 2019
- Last Updated
- February 01, 2023
Practice Location
- 600 Fishers Station Dr Ste 117
- Victor, NY 14564-9784
Phone: (585) 337-0992
Specialties
- Psychiatric/Mental Health Nurse Practitioner (363LP0808X)
- Nurse Practitioner (363L00000X)
Full Record
- NPI
- 1194281444
- Entity Type
- Individual
- Last Name
- Manjgaladze
- First Name
- Angela
- Mailing Street Address
- 600 Fishers Station Dr Ste 117
- Mailing City
- Victor
- Mailing State
- NY
- Mailing ZIP Code
- 14564-9784
- Mailing Country
- US
- Mailing Phone
- (585) 337-0992
- Mailing Fax
- (585) 337-0998
- Practice Street Address
- 600 Fishers Station Dr Ste 117
- Practice City
- Victor
- Practice State
- NY
- Practice ZIP Code
- 14564-9784
- Practice Country
- US
- Practice Phone
- (585) 337-0992
- Practice Fax
- (585) 337-0998
- Enumeration Date
- February 12, 2019
- Last Updated
- February 01, 2023
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- February 04, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Psychiatric/Mental Health Nurse Practitioner (363LP0808X), Nurse Practitioner (363L00000X)