Individual
PATRICIA K MANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 689-8333
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(631) 689-8333
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
309272
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
309272
NY
Other
Enumeration date
04/17/2020
Last updated
02/06/2021
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