Individual
MS. JACKIE STARR MANARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTL
Contact information
Practice address
590 AVENUE OF THE AMERICAS, NEW YORK, NY 10011-2019
(646) 459-3600
Mailing address
55 ELWOOD AVE, STATEN ISLAND, NY 10314-6020
(917) 459-6629
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
016718
NY
Other
Enumeration date
05/09/2011
Last updated
05/09/2011
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