Individual
MISS LENORE ODESSA MANGASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
280 MARIN BLVD APT 21F, JERSEY CITY, NJ 07302-3689
(646) 265-1162
Mailing address
PO BOX 13642, PHILADELPHIA, PA 19101-3642
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
007003-1
NY
Other
Enumeration date
03/29/2012
Last updated
08/21/2024
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