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Provider Information for 1265977938


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Mr. CHARLES MANI IGNATIUS


Sex: Male

NPI: 1265977938
Last Updated: 2023-10-18
Certification Date: 2023-10-18

Details

NameValue
NPI1265977938
Enumeration Date2017-01-04
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 7 WAINWRIGHT AVE
APT-1A
YONKERS, NY 10710-5843
United States

Phone: 347-452-4122 | Fax:
 
Primary Practice Address 7 WAINWRIGHT AVE
APT-1A
YONKERS, NY 10710-5843
United States

Phone: 347-452-4122 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 102L00000X - Psychoanalyst NY001187