Individual
MRS. MARINA MANUSOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
57 W 57TH ST, NEW YORK, NY 10019-2802
(212) 751-6428
Mailing address
7811 35TH AVE APT 5A, JACKSON HEIGHTS, NY 11372-2539
(718) 505-9644
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
023998-1
NY
Other
Enumeration date
08/28/2008
Last updated
08/28/2008
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