Individual
ATHENA JANE MANATIS-LORNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
593 EDDY STREET, PROVIDENCE, RI 02903
(401) 444-4393
Mailing address
593 EDDY STREET, PROVIDENCE, RI 02903
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
LP05919
RI
390200000X
Student in an Organized Health Care Education/Training Program
LP05919
RI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/04/2021
Last updated
06/23/2023
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