National Provider Identifier

Manal Ismail Fallatah, RN, BSN, MSN.

Manal Ismail Fallatah, RN, BSN, MSN. is listed in the NPPES registry with a primary specialty of Registered Nurse in Victor, NY and a listed phone number of (585) 200-0553.

NPI 1467136309Victor, NYRegistered Nurse

Profile Overview

NPI
1467136309
Provider Type
Individual
Primary Specialty
Registered Nurse
Enumeration Date
June 12, 2023
Last Updated
June 13, 2023

Practice Location

  • 531 Championship Dr
  • Victor, NY 14564-8810

Phone: (585) 200-0553

Specialties

  • Registered Nurse (163W00000X)
Full Record
NPI
1467136309
Entity Type
Individual
Last Name
Fallatah
First Name
Manal
Middle Name
Ismail
Name Prefix
MS.
Credential
RN, BSN, MSN.
Provider Other Last Name
Johnston
Provider Other First Name
Manal
Provider Other Name Prefix Text
MS.
Provider Other Credential Text
RN, BSN, MSN.
Provider Other Last Name Type Code
2
Mailing Street Address
531 Championship Dr
Mailing City
Victor
Mailing State
NY
Mailing ZIP Code
14564-8810
Mailing Country
US
Mailing Phone
(585) 200-0553
Practice Street Address
531 Championship Dr
Practice City
Victor
Practice State
NY
Practice ZIP Code
14564-8810
Practice Country
US
Practice Phone
(585) 200-0553
Enumeration Date
June 12, 2023
Last Updated
June 13, 2023
Sex
Female
Sole Proprietor
Yes
Certification Date
June 13, 2023
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Registered Nurse (163W00000X)