Individual
AMY MANGLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1425 PORTLAND AVE # 287, ROCHESTER, NY 14621-3001
(585) 922-5067
(585) 922-2908
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 922-0553
(585) 922-0496
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
278143
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04056713
—
NY
Enumeration date
07/11/2011
Last updated
12/09/2018
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