Individual
MR. LAWRENCE MANCINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
360 EDISON ST, STATEN ISLAND, NY 10306
(718) 351-6377
(718) 980-7341
Mailing address
360 EDISON ST, STATEN ISLAND, NY 10306
(718) 351-6377
(718) 980-7341
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
185177
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01600628
—
NY
01
—
110145269
RR MEDICARE
NY
Enumeration date
01/30/2006
Last updated
05/15/2008
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