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NPI Code Detail

MEDICARE: MARYLUZ MANN

MEDICARE: MARYLUZ MANN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist015394-1NY

General Provider Information

NPI Number : 1407493281
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARYLUZ MANN
Provider Business Mailing Address
First Line : 460 ANDES RD
Second Line :
City : DELHI
State : NY
Zip : 13753-7443
Country : US
Telephone Number : 607-746-0329
Fax Number : 607-746-0474
Provider Business Practice Location Address
First Line : 460 ANDES RD
Second Line :
City : DELHI
State : NY
Zip : 13753-7443
Country : US
Telephone Number : 607-746-0329
Fax Number : 607-746-0474
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2019
Last Update Date : 11/29/2019

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Directions to “ MARYLUZ MANN ” Practice Location

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