Individual
MRS. CHRISTINE MAMMARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
31 MERRICK AVE, MERRICK, NY 11566-3477
(917) 582-0889
Mailing address
170 E SHORE DR, MASSAPEQUA, NY 11758-7620
(917) 582-0889
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
310365
NY
Other
Enumeration date
07/16/2021
Last updated
08/24/2021
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