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Individual

LISA MANISERO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
800 POLY PL, BROOKLYN, NY 11209-7104
(718) 630-3660
Mailing address
2375 STUART ST, BROOKLYN, NY 11229-5813
(917) 992-6144

Taxonomy

Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
949002
NY
2471M2300X
Mammography Radiologic Technologist
949002
NY

Other

Enumeration date
09/16/2015
Last updated
09/16/2015
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