Individual
ANDREA MARIE MANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 IRVING AVE, SYRACUSE, NY 13210-2716
(315) 425-4400
Mailing address
11612A MULBERRY AVE, FORT DRUM, NY 13603-3250
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
526132
TN
Other
Enumeration date
08/25/2023
Last updated
08/25/2023
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