Individual
JODI MANISCALCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
115 W SILVER ST, WESTFIELD, MA 01085-3628
(413) 568-2811
(610) 834-2862
Mailing address
PO BOX 419218, BOSTON, MA 02241-9218
(855) 691-9890
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1064
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970016569
RAILROAD MEDICARE
MA
Enumeration date
06/04/2006
Last updated
01/17/2018
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