Individual
DR. AMIRA MANTOURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1425 BEDFORD ST STE 1H, STAMFORD, CT 06905-5203
(203) 975-1175
Mailing address
1425 BEDFORD ST STE 1H, STAMFORD, CT 06905-5203
(203) 975-1175
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000430
CT
332B00000X
Durable Medical Equipment & Medical Supplies
000430
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4078029
—
CT
Enumeration date
07/12/2006
Last updated
03/22/2025
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