Individual
STEPHANIE DAVID MANCINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, ATC
Contact information
Practice address
365 MONTAUK AVE, NEW LONDON, CT 06320-4769
(860) 271-4655
Mailing address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
001582
CT
2255A2300X
Athletic Trainer
003031-1
NY
363A00000X
Physician Assistant
Primary
6371
CT
Other
Enumeration date
08/07/2019
Last updated
10/22/2024
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