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NPI Code Detail

MEDICARE: MS. KRISTINA DANIELLE MANCINI PA-C

MEDICARE: MS. KRISTINA DANIELLE MANCINI PA-C
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
1363A00000XPhysician Assistant25MP00260200NJ

General Provider Information

NPI Number : 1558648790
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KRISTINA DANIELLE MANCINI PA-C
Provider Business Mailing Address
First Line : 400 GILL LN
Second Line :
City : ISELIN
State : NJ
Zip : 08830-3059
Country : US
Telephone Number : 732-404-1580
Fax Number :
Provider Business Practice Location Address
First Line : 400 GILL LN
Second Line :
City : ISELIN
State : NJ
Zip : 08830-3059
Country : US
Telephone Number : 732-404-1580
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2011
Last Update Date : 11/15/2011

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Directions to “ MS. KRISTINA DANIELLE MANCINI PA-C” Practice Location

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