Individual
ALICE MANGRU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21015 23RD AVE, BAYSIDE, NY 11360-1845
(347) 254-9959
Mailing address
21015 23RD AVE, BAYSIDE, NY 11360-1845
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
343844
NY
Other
Enumeration date
10/06/2022
Last updated
10/06/2022
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