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
Certification Date: 2023-10-18
Details
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NPI | 1265977938 | ||||||||
Enumeration Date | 2017-01-04 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
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: | ||||||||
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