Provider Demographics
NPI:1609675123
Name:MANLEY, MALIKA JOENELL (LPN)
Entity type:Individual
Prefix:
First Name:MALIKA
Middle Name:JOENELL
Last Name:MANLEY
Suffix:
Gender:
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 SENECA PKWY APT 2
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14613-1412
Mailing Address - Country:US
Mailing Address - Phone:585-642-1838
Mailing Address - Fax:
Practice Address - Street 1:129 SENECA PKWY APT 2
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14613-1412
Practice Address - Country:US
Practice Address - Phone:585-642-1838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-08
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY337474164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse