Kelly Manzella

NPI #1154206944 in Massapequa Park, New York

Provider Information

NPI Number: 1154206944
Entity Type: Individual
Name: Kelly Manzella
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Aug 11, 2025
Last Updated: Aug 11, 2025

Practice Location

Address: 301 PENNSYLVANIA AVE
City: Massapequa Park
State: New York
ZIP Code: 11762-2848
Phone: (516) 547-6662

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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