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NPI Code Detail

MEDICARE: EMILY ROSE MANKUS

MEDICARE: EMILY ROSE MANKUS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant7331CT

General Provider Information

NPI Number : 1326910043
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY ROSE MANKUS
Provider Business Mailing Address
First Line : 20 YORK ST
Second Line :
City : NEW HAVEN
State : CT
Zip : 06510-3220
Country : US
Telephone Number : 203-688-2046
Fax Number :
Provider Business Practice Location Address
First Line : 20 YORK ST
Second Line :
City : NEW HAVEN
State : CT
Zip : 06510-3220
Country : US
Telephone Number : 203-688-2046
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2025
Last Update Date : 12/12/2025

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Directions to “ EMILY ROSE MANKUS ” Practice Location

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