Individual
MR. ELVIS MANZANILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2005 PALMER AVE # 231, LARCHMONT, NY 10538-2437
(347) 259-9156
Mailing address
2005 PALMER AVE # 231, LARCHMONT, NY 10538-2437
(347) 259-9156
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
04/15/2012
Last updated
04/15/2012
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