Individual
ASPASIA MANETTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4321
Mailing address
436 E 116TH ST APT 3, NEW YORK, NY 10029-1618
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/13/2019
Last updated
07/13/2019
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