Individual
KRISTEN DENISE MANTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1249 NOSTRAND AVE, BROOKLYN, NY 11225-3844
(718) 765-6008
(347) 682-4219
Mailing address
PO BOX 746087, ATLANTA, GA 30374-6087
(312) 733-9730
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
228042
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00357451
—
NY
01
—
112467268MA01
CAREPLUS
—
01
—
204590101
HEALTHPLUS
—
01
—
40426028484
FIDELIS
—
01
—
P3614958
OXFORD
—
01
—
PC4845
CENTERCARE CHP
—
01
—
PPO5996243
GHI
—
Enumeration date
02/24/2006
Last updated
11/12/2024
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