VYACHESLAV MAMANOV NP
NPI 1154095677
Nurse Practitioner - Adult Health in Forest Hills, NY

Q: What is Vyacheslav Mamanov's NPI number?

The NPI number for Vyacheslav Mamanov is 1154095677. It was assigned to this individual provider in the NPPES registry on August 7, 2021.

Q: What is Vyacheslav Mamanov's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Active since August 07, 2021

10218 64TH AVE, FOREST HILLS, NY 11375(646) 479-9710 Get Directions Write a Review

NPPES record last updated: August 7, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Vyacheslav Mamanov Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VYACHESLAV MAMANOV NP (NPI 1154095677) is an individual adult health provider in Forest Hills, New York, licensed in New York (310305) and active in the NPI registry since August 2021.

NPPES Registry Identity

NPI1154095677

Entity TypeIndividualMale

Primary Taxonomy363LA2200X

Provider Legal NameVYACHESLAV MAMANOVCredential: NP

Location Address10218 64TH AVEForest Hills, NY 11375-1548

Mailing Address10218 64th AveForest Hills, NY 11375-1548

Phone(646) 479-9710

Sole ProprietorNo

Enumeration DateAugust 7, 2021

NPPES CertifiedAugust 7, 2021

✔ NPI 1154095677 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in NY · 310305

10218 64TH AVE, Forest Hills, NY 11375

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vyacheslav Mamanov's NPI number?

The NPI number for Vyacheslav Mamanov is 1154095677. It was assigned to this individual provider in the NPPES registry on August 7, 2021.

Where is Vyacheslav Mamanov located?

Vyacheslav Mamanov practices at 10218 64th Ave, Forest Hills, NY 11375. The listed phone number is (646) 479-9710.

What is Vyacheslav Mamanov's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

When was this NPI record last updated?

The NPPES record for Vyacheslav Mamanov was last updated on August 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.