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General NPI Number Information
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NPI Number | 1821594151
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Entity Type | Individual
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Provider Name | GINA MARIE MANGIONE MD
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Gender | Female
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Dates
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Enumeration Date | 04/04/2018
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 111 N MAPLEMERE RD STE 200
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-3182
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Country | US
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Telephone | 716-626-2644
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Fax |
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Provider Business Mailing Address
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Address Line | 462 GRIDER ST
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City | BUFFALO
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State | NY
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Zip | 14215-3021
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Country | US
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Telephone | 716-898-3941
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 304160
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 304160
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License Number State | NY
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