DERRICK ANTHONY MANZLAK (NPI# 1235429457) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235429457 |
| Entity Type | Individual |
| Full Name | DERRICK ANTHONY MANZLAK |
| Credential | M.D. |
| Practice Address |
1101 Sam Perry Blvd Ste 411 Fredericksburg VA 22401-4466 |
| Mailing Address |
1101 Sam Perry Blvd Suite 411 Fredericksburg VA 22401-4466 |
| Practice Telephone | (540) 741-7846 |
| Practice Fax Number | 5407411632 |
| Mailing Telephone | (540) 741-7846 |
| Mailing Fax Number | 5407411632 |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
261728 | MA | Allopathic & Osteopathic Physicians |
| Y | 2084S0012X |
Psychiatry & Neurology Specialization: Sleep Medicine |
0101262628 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1235429457 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Boston Medical Ctr Pl, Boston, MA 021182908 | 6174145245 |
| Street Address |
1101 SAM PERRY BLVD STE 411 |
| City | FREDERICKSBURG |
| State | VA |
| Zip Code | 22401-4466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861739518 | Pascal Ngongmon | Internal Medicine | 1101 Sam Perry Blvd Ste 411, Fredericksburg, VA 22401-4466 | 2013-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992313415 | Amanda Dodd | Behavior Technician | 1411 Princess Anne, Fredericksburg, VA 22401 | 2020-07-21 |
| 1215567326 | Britteny Whitaker | Behavior Technician | 1411 Princess Ann, Fredericksburg, VA 22401 | 2020-01-17 |
| 1396389433 | Ashley Stanevich | Behavior Technician | 1411 Princess Anne Lane, Fredericksburg, VA 22401 | 2019-11-01 |
| 1265074231 | Anna Kelleher | Behavior Technician | 1411 Princess Anna St, Frericksburg, VA 22401 | 2019-10-11 |
| 1649824152 | Zaan Z Ali | Audiologist | 1708 Fall Hill Ave Suite 100, Fredericksburg, VA 22401 | 2019-08-01 |
| 1790342426 | Michael Williams Jr. | Physician Assistant | 411 B Park Hill Dr, Frederickburg, VA 22401 | 2019-05-29 |
| 1285290965 | Ann Damalie Namabiro | Behavior Technician | 1411 Princess Ann Street, Fredericksburg, VA 22401 | 2019-05-17 |
| 1922579630 | Primary and Urgent Care LLC | Family Medicine | Primary and Urgent Care LLC, 2306 Plank Road Ste 100, Fredericksburg, VA 22401 | 2018-12-07 |
| 1003323056 | Mariah Mazzariello | Behavior Technician | 1411 Princess Anne Stree, Fredericksburg, VA 22401 | 2017-12-29 |
| 1336655281 | Hina Zafar | Behavior Technician | 1411 Princess Anne St., Fredericksburg, VA 22401 | 2017-12-14 |
| Find all providers in zip 22401 | ||||
| Taxonomy Code | 2084S0012X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Sleep Medicine |
| A Psychiatrist or Neurologist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders. |
| Notes: Source: American Academy of Sleep Medicine, www.aasm.org [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114170446 | Riverside Physician Services Inc | Psychiatry & Neurology | 7547 Medial Drive, Suite 1300, Gloucester, VA 23061 | 2008-10-30 |
| 1982002937 | Loudoun Medical Group PC | Psychiatry & Neurology | 8100 Ashton Ave, Suite 200, Manassas, VA 20109-5622 | 2014-12-08 |
| 1033546908 | Neuroscience Consultants, Plc | Psychiatry & Neurology | 12007 Sunrise Valley Dr, Suite 130, Reston, VA 20191-3479 | 2013-10-08 |
| 1467896670 | Elsie Achieng | Psychiatry & Neurology | 12200 Warwick Blvd Ste 410, Newport News, VA 23601-2548 | 2013-04-18 |
| 1699012161 | Neurosleep Medical Consulting Services Plc | Psychiatry & Neurology | 8300 Boone Blvd, Suite 130, Vienna, VA 22182-2626 | 2013-01-03 |
| 1245294024 | Nancy Doralie Morewitz | Psychiatry & Neurology | 3640 High St, Suite 1a, Portsmouth, VA 23707-3213 | 2006-04-17 |
| City | FREDERICKSBURG |
| Zip Code | 22401 |
Please comment or provide details below to improve the information on DERRICK ANTHONY MANZLAK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.