Fairy Laine Espina Manzano
Fairy Laine Espina Manzano is a Nurse Practitioner in Lynbrook, New York. Qualified in 2025, 1 year ago. Practices with Interborough Developmental and Consultation Center Inc, a 152-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.
- Years since qualifying
- 1
- Licensed in
- NY
- In the registry since
- 2020
- Specialties on file
- 2
Practice location Address checks out
20 Exeter AveLynbrook, NY 11563-3710
Phone: (347) 351-2454
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Psychiatric/Mental Health Nurse Practitioner (primary) | Taxonomy 363LP0808X · Licence 406726 (NY) |
|---|---|
| Psychiatric/Mental Health Registered Nurse | Taxonomy 163WP0808X · Licence 730040 (NY) |
Record details
| NPI number | 1417572173 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | June 9, 2020 |
| Last updated in NPPES | April 13, 2025 |
| Certification date | April 13, 2025 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2025 (1 years in practice) |
| Group practice | Interborough Developmental And Consultation Center Inc — 152 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Telehealth | Offers telehealth services |