Individual
MARIO GAVAN MANACCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, BSN
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 444-2200
Mailing address
17819 AUBURN RD, CHAGRIN FALLS, OH 44023-6130
(440) 708-4721
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.428670
OH
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN.CNP.024360
OH
Other
Enumeration date
11/26/2018
Last updated
03/06/2019
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