Individual
CONSTADINA MANETTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1456 FULTON ST, BROOKLYN, NY 11216-2505
(718) 636-4500
Mailing address
436 E 116TH ST APT 3, NEW YORK, NY 10029-1618
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
009253
NY
Other
Enumeration date
09/10/2020
Last updated
11/25/2020
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