Individual
LUIS MANZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
104 E 40TH ST, SUITE 406, NEW YORK, NY 10016-1801
(347) 534-8798
Mailing address
892 UNION ST, BROOKLYN, NY 11215-1602
(347) 534-8798
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
016307
NY
103TA0400X
Addiction (Substance Use Disorder) Psychologist
016307
NY
103TC1900X
Counseling Psychologist
016307
NY
103TE1100X
Exercise & Sports Psychologist
016307
NY
Other
Enumeration date
12/01/2009
Last updated
12/01/2009
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