Individual
MISS DENISE ANDREA MANCILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9004 161ST ST, JAMAICA, NY 11432-6141
(718) 206-1000
Mailing address
9004 161ST ST, JAMAICA, NY 11432-6141
(718) 206-1000
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/04/2012
Last updated
09/04/2012
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