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Individual
MR. JUSTIN MANGANARO
Active
Individual
MR. JUSTIN MANGANARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
083906-23
NH
363LP0200X
Pediatric Nurse Practitioner
APRN00140
RI
363LP0200X
Pediatric Nurse Practitioner
RN266873
MA
Other
Enumeration date
12/15/2010
Last updated
02/03/2021
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