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NPI Code Detail

MEDICARE: PRATHEEK MANGINI

MEDICARE: PRATHEEK MANGINI
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
12084P0800XPsychiatry PhysicianMD491309PA

General Provider Information

NPI Number : 1265003966
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRATHEEK MANGINI
Provider Business Mailing Address
First Line : 3900 WOODLAND AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4551
Country : US
Telephone Number : 215-823-5800
Fax Number :
Provider Business Practice Location Address
First Line : 3900 WOODLAND AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4551
Country : US
Telephone Number : 215-823-5800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2021
Last Update Date : 12/08/2025

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Directions to “ PRATHEEK MANGINI ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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