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NPI Code Detail

MEDICARE: MRS. NATALIE LA MANTIA

MEDICARE: MRS. NATALIE LA MANTIA
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1417392796
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NATALIE LA MANTIA
Provider Business Mailing Address
First Line : 305 PALISADE AVE
Second Line : APT 210
City : CLIFFSIDE PARK
State : NJ
Zip : 07010-4737
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 37 EVERGREEN PL
Second Line :
City : EAST ORANGE
State : NJ
Zip : 07018-2154
Country : US
Telephone Number : 973-266-7983
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2013
Last Update Date : 05/01/2013

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Directions to “ MRS. NATALIE LA MANTIA ” Practice Location

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