Individual
KATHLEEN MANGIARACINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2121 AVENUE C, MERRICK, NY 11566-4758
(718) 240-6400
Mailing address
2121 AVENUE C, MERRICK, NY 11566-4758
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
NY
Other
Enumeration date
07/25/2008
Last updated
07/25/2008
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