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General NPI Number Information
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NPI Number | 1760197230
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Entity Type | Individual
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Provider Name | REGINA MARIE MANGANO APN
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Gender | Female
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Dates
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Enumeration Date | 01/19/2023
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 698 MULLICA HILL RD STE 330
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City | MULLICA HILL
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State | NJ
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Zip | 08062-4453
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Country | US
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Telephone | 856-845-3707
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Fax |
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Provider Business Mailing Address
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Address Line | 1 FEDERAL ST STE 200
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City | CAMDEN
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State | NJ
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Zip | 08103-1088
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Country | US
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Telephone | 848-288-6935
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NJ14913200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 26NR19441000
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License Number State | NJ
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