Individual
MICHELE JILL MANGINELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
16808 18TH AVE, WHITESTONE, NY 11357-3311
(718) 570-2953
Mailing address
16808 18TH AVE, WHITESTONE, NY 11357-3311
(718) 570-2953
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F383465
NY
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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