Individual
MISS ELVIA ELIZABETH MANRIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
35 LONGWOOD ROAD, MIDDLE ISLAND, NY 11953
(631) 924-1000
Mailing address
354 BROADWAY, PORT JEFFERSON STATION, NY 11776
(631) 473-7518
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F336031-1
NY
Other
Enumeration date
04/05/2010
Last updated
04/05/2010
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