Healthcare Provider Details

I. General information

NPI: 1134107535
Provider Name (Legal Business Name): DAVID MANCINI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 S MAIN ST
RED LION PA
17356-2605
US

IV. Provider business mailing address

718 S MAIN ST
RED LION PA
17356-2605
US

V. Phone/Fax

Practice location:
  • Phone: 717-244-8504
  • Fax: 717-244-5401
Mailing address:
  • Phone: 717-244-8504
  • Fax: 717-244-5401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMD419997
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: