Individual ProviderNathan ManningStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address662 West 168th Street, Ph 1-317, Nyph-Columbia Campus.Department Of Radiology, New York, NY 10032(929) 444-0189PECOS EnrollmentBased on the most recent information from CMS, provider Nathan Manning does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1053729087Provider TypeIndividualFull NameManning, NathanTitleDr.CredentialM.B.B.S.GenderMaleSole ProprietorNoEnumeration Date7/22/2014Last Updated7/22/2014Contact InformationPractice LocationPractice Address662 West 168th Street, Ph 1-317, Nyph-Columbia Campus.Department Of Radiology, New York, NY 10032Phone(929) 444-0189FaxUnlisted FaxMailing LocationMailing Address662 West 168th Street, Ph 1-317, Nyph-Columbia Campus.Department Of Radiology, New York, NY 10032Phone(929) 444-0189FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseP94086New York