Individual
MS. TRACY MANNERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1770 MOTOR PKWY, HAUPPAUGE, NY 11749-5260
(631) 434-1770
Mailing address
5 SEABROOK CT, STONY BROOK, NY 11790-3305
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
831834
NY
Other
Enumeration date
11/16/2006
Last updated
07/08/2007
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