Individual provider · NPI-1

Manuel Cifuentes

Registered Nurse, General Practice · Staten Island, NY

NPI number1811548019
StatusActive
Last updated in NPPESJun 19, 2025

Details

NPI
1811548019
Entity type
Individual (NPI-1)
Name
Manuel Cifuentes
Sex
Male
Sole proprietor
Yes
Enumeration date
Sep 28, 2019
Certification date
Jun 19, 2025
Last updated
Jun 19, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WG0000X Registered Nurse, General Practice742550-1NYYes
363LF0000X Nurse Practitioner, Family349509NY

Practice location

646 Willowbrook Rd
Staten Island, NY 10314-6826

Phone 786-608-3233

Mailing address

646 Willowbrook Rd
Staten Island, NY 10314-6826

Phone 786-608-3233

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Registered Nurse, General Practice providers in Staten Island, NY