| Healthy Male Institute | |
|
425 Pleasant St Brockton MA 02301-2533 | |
| (617) 694-7172 | |
| Not Available |
| Full Name | Healthy Male Institute |
|---|---|
| Speciality | Clinic/Center |
| Location | 425 Pleasant St, Brockton, Massachusetts |
| Authorized Official Name and Position | Phernel Joseph Manigat (OWNER AND FOUNDER) |
| Authorized Official Contact | 6176947172 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthy Male Institute 218 Sawtell Ave Brockton MA 02302-1654 Ph: (617) 694-7172 | Healthy Male Institute 425 Pleasant St Brockton MA 02301-2533 Ph: (617) 694-7172 |
| NPI Number | 1144796491 |
|---|---|
| Provider Enumeration Date | 10/15/2018 |
| Last Update Date | 10/15/2018 |
| Medicare PECOS PAC ID | 9931446622 |
|---|---|
| Medicare Enrollment ID | O20190204002585 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144796491 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Ernst Manigat |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386701688 PECOS PAC ID: 6002729142 Enrollment ID: I20031106000130 |
| Provider Name | Phernel J Manigat |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679762447 PECOS PAC ID: 6002153798 Enrollment ID: I20190412000687 |
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