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

Vyacheslav Mamanov, NP

Individual provider Adult Health Nurse Practitioner · NPI 1154095677

Vyacheslav Mamanov, NP is an Adult Health Nurse Practitioner in Forest Hills, New York. Licensed in New York. Registered with an NPI since 2021.

Licensed in
NY
In the registry since
2021
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

See every abbreviation used in this directory →

Practice location Address checks out

10218 64th Ave
Forest Hills, NY 11375-1548
Phone: (646) 479-9710
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 310305 (NY)

Record details

NPI number1154095677
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedAugust 7, 2021
Last updated in NPPESAugust 7, 2021
Certification dateAugust 7, 2021

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