Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ayesha Mannan, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1497243703

Ayesha Mannan, DO is a Family Practice in Massapequa, New York. Graduated from New York College of Osteo Medicine of New York Institute of Technology in 2018, 8 years ago. Practices with Long Island Comprehensive Medical Care PLLC, a 41-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
8
Trained at
New York College of Osteo Medicine of New York Institute of Technology
Licensed in
NY
In the registry since
2018
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

515 Broadway
Massapequa, NY 11758-5005
Phone: (631) 667-0388
Fax: (631) 968-7705
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1231 Deer Park Ave, North Babylon, NY 11703-3104 — (631) 667-0388

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 308856 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1497243703
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorYes
NPI enumeratedApril 23, 2018
Last updated in NPPESJune 23, 2021
Certification dateJune 23, 2021
Mailing address1000 Montauk Hwy, West Islip, NY 11795-4927

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolNEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
Graduated 2018 (8 years in practice)
Group practice Long Island Comprehensive Medical Care Pllc — 41 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Massapequa