ANGELA MANJGALADZE NPI 1194281444

NPI Information

  • NPI: 1194281444
  • Provider Name: ANGELA MANJGALADZE
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 600 FISHERS STATION DR STE 117
    VICTOR, NY
    ZIP 14564
  • Phone: (585) 337-0992

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NPI Details

Angela Manjgaladze is a psychiatric/mental health nurse practitioner in Victor, NY with 7 years of experience. Angela Manjgaladze NPI is 1194281444. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

600 FISHERS STATION DR STE 117
VICTOR, NY
ZIP 14564-784
Phone: (585) 337-0992
Fax: (585) 337-0998

The NPI 1194281444 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/12/2019 and was last updated on 2/1/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse Practitioner001782NEW YORKNo
2363LP0808XNurse PractitionerPsychiatric/Mental Health402705NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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