Healthcare Provider Details

I. General information

NPI: 1053270074
Provider Name (Legal Business Name): MARLAINA MARIE MANCINI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 ROUTE 9
WAPPINGERS FALLS NY
12590-2827
US

IV. Provider business mailing address

1575 ROUTE 9
WAPPINGERS FALLS NY
12590-2827
US

V. Phone/Fax

Practice location:
  • Phone: 845-632-9020
  • Fax: 845-632-9026
Mailing address:
  • Phone: 845-632-9020
  • Fax: 845-632-9026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number073643
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: