Provider Demographics
NPI:1770846560
Name:MANKOS, ZITA AMOR CANARY (TEACHER)
Entity Type:Individual
Prefix:MRS
First Name:ZITA AMOR
Middle Name:CANARY
Last Name:MANKOS
Suffix:
Gender:F
Credentials:TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07502-1851
Mailing Address - Country:US
Mailing Address - Phone:201-240-1044
Mailing Address - Fax:
Practice Address - Street 1:110 UNION AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07502-1851
Practice Address - Country:US
Practice Address - Phone:201-240-1044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist