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General NPI Number Information
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NPI Number | 1821615873
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Entity Type | Individual
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Provider Name | AL'TIANA MANNING OD
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Gender | Female
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Dates
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Enumeration Date | 06/25/2020
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 1979 MARCUS AVENUE SUITE 206
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City | LAKE SUCCESS
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State | NY
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Zip | 11042
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Country | US
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Telephone | 516-243-8611
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3076
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City | WEST MEMPHIS
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State | AR
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Zip | 72303-3076
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Country | US
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Telephone | 912-713-6015
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901005570
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 003213
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV009456
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1045
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License Number State | NH
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Taxonomy #5
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00708500
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License Number State | NJ
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Taxonomy #6
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT003489
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License Number State | GA
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Taxonomy #7
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3979-35
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License Number State | WI
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Taxonomy #8
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3609
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License Number State | TN
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