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Individual

DR. MARILYN MANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
612 CORPORATE WAY, SUITE 3, VALLEY COTTAGE, NY 10989-2021
(845) 268-0045
(845) 268-0998
Mailing address
358 PLEASANT HILL DR, NEW CITY, NY 10956-2213
(845) 634-3240

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
270A00445400
NJ
152W00000X
Optometrist
OPC1998
FL
152W00000X
Optometrist
Primary
VUT004435-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P674678
OXFORD
Enumeration date
02/08/2006
Last updated
03/08/2010
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