Provider Demographics
NPI:1447653969
Name:ZRAIK, MANAL ASEIN (MS)
Entity type:Individual
Prefix:MRS
First Name:MANAL
Middle Name:ASEIN
Last Name:ZRAIK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MRS
Other - First Name:MANAL
Other - Middle Name:ASEIN
Other - Last Name:VASSALLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:8485 NEWBURY PLACE
Mailing Address - Street 2:
Mailing Address - City:CLAY
Mailing Address - State:NY
Mailing Address - Zip Code:13041
Mailing Address - Country:US
Mailing Address - Phone:315-256-8267
Mailing Address - Fax:
Practice Address - Street 1:8485 NEWBURY PLACE
Practice Address - Street 2:
Practice Address - City:CLAY
Practice Address - State:NY
Practice Address - Zip Code:13041
Practice Address - Country:US
Practice Address - Phone:315-256-8267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist