Healthcare Provider Details

I. General information

NPI: 1467317081
Provider Name (Legal Business Name): DANIEL R MANGINE PHD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 WHITE AVE
CRAFTON PA
15205-2847
US

IV. Provider business mailing address

39 WHITE AVE
CRAFTON PA
15205-2847
US

V. Phone/Fax

Practice location:
  • Phone: 412-716-3047
  • Fax: 412-922-3230
Mailing address:
  • Phone: 412-716-3047
  • Fax: 412-922-3230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL REED MANGINE
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 412-716-3047