Individual
MARISSA MANFREDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14 RUTGERS RD, FARMINGVILLE, NY 11738-1467
(631) 355-6832
Mailing address
14 RUTGERS RD, FARMINGVILLE, NY 11738-1467
(631) 355-6832
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
891057141
NY
Other
Enumeration date
02/11/2016
Last updated
02/11/2016
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