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General NPI Number Information
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NPI Number | 1750716981
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Entity Type | Individual
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Provider Name | EMMA CAROLINE MANGANO PMH-NP
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Gender | Female
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Dates
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Enumeration Date | 09/06/2013
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Last Update Date | 11/28/2023
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Provider Practice Location Address
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Address Line | 1740 YORK RD SUITE 309
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City | LUTHERVILLE TIMONIUM
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State | MD
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Zip | 21093-5606
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Country | US
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Telephone | 410-825-2281
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Fax |
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Provider Business Mailing Address
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Address Line | 1740 YORK RD SUITE 309
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City | LUTHERVILLE TIMONIUM
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State | MD
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Zip | 21093-5606
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Country | US
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Telephone | 410-825-2281
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R179858
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License Number State | MD
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