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Individual

MISS JANINE MARY MANSUKHANI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
350 ENGLE ST FL 5, ENGLEWOOD, NJ 07631-1808
(201) 894-3636
Mailing address
40 CONCORD LN, STATEN ISLAND, NY 10304-1343
(646) 823-4212

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
013151
NY
363A00000X
Physician Assistant
Primary
25MP00653600
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0893552
NJ
Enumeration date
03/25/2009
Last updated
04/08/2024
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