Kimberly Manzo
Specialist in Staten Island, NY. Individual provider (NPI-1).
NPI number1669919940
StatusActive
Last updated in NPPESJan 25, 2017
Details
- NPI
- 1669919940
- Entity type
- Individual (NPI-1)
- Name
- Kimberly Manzo
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 25, 2017
- Last updated
- Jan 25, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 888943 | NY | Yes |
Practice location
35 Poplar AveStaten Island, NY 10309-1614
Phone 917-559-9225
Mailing address
35 Poplar AveStaten Island, NY 10309-1614
Phone 917-559-9225
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