Individual
PAULA DAGROSA-MANSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.N.P.
Contact information
Practice address
400 HORSEBLOCK RD, FARMINGVILLE, NY 11738
(631) 451-2211
Mailing address
2 HEATH CT, STONY BROOK, NY 11790-2316
(631) 751-2855
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F304984-1
NY
Other
Enumeration date
07/29/2009
Last updated
07/29/2009
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