Individual
AMANDA MAMMANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
110 MERCER ST, NEW YORK, NY 10012-3865
(212) 431-4440
(212) 431-4404
Mailing address
1200 W GODFREY AVE, PHILADELPHIA, PA 19141-3323
(215) 276-6173
(215) 276-1329
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OEG003061
PA
152W00000X
Optometrist
Primary
TUV008412
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13584891
CAQH NUMBER
PA
Enumeration date
07/10/2015
Last updated
11/29/2018
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