Individual
MS. ELAINE R MANGINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
57 WATER ST, BLUE HILL, ME 04614-5231
(207) 374-3930
Mailing address
57 WATER ST, BLUE HILL, ME 04614-5231
(207) 374-3930
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA861
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255383527
—
ME
Enumeration date
05/16/2006
Last updated
12/21/2020
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