Individual
CARRIE LYN MANGANARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 TULIP CT, MORICHES, NY 11955-1901
(631) 655-3818
Mailing address
11 TULIP CT, MORICHES, NY 11955-1901
(631) 655-3818
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
314519-1
NY
Other
Enumeration date
04/30/2014
Last updated
04/30/2014
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