Individual
MS. KATIE LYNN MANNINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
440 CURRY AVE STE A, ENGLEWOOD, NJ 07631-1794
(201) 227-1299
Mailing address
204 8TH ST APT 3, HOBOKEN, NJ 07030-4163
(732) 546-7122
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00638700
NJ
Other
Enumeration date
09/09/2021
Last updated
09/09/2021
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