Provider Demographics
NPI:1164931580
Name:MANZANO, CLARA INES (SPECIAL EDUCATION)
Entity Type:Individual
Prefix:MRS
First Name:CLARA
Middle Name:INES
Last Name:MANZANO
Suffix:
Gender:F
Credentials:SPECIAL EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10220 67TH DR APT 204
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2809
Mailing Address - Country:US
Mailing Address - Phone:917-396-0331
Mailing Address - Fax:
Practice Address - Street 1:3636 33RD ST STE 500
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11106-2329
Practice Address - Country:US
Practice Address - Phone:212-529-9780
Practice Address - Fax:212-529-9866
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-28
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist