Individual
JULIANA MANTEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
80 PHOENIX AVE, WATERBURY, CT 06702-1418
(203) 756-8021
Mailing address
614 FENN RD, NEWINGTON, CT 06111-1704
(860) 416-5971
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
011064
CT
Other
Enumeration date
10/05/2022
Last updated
10/05/2022
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