Individual
GRAHAM MANGINI-HAROLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
725 AIRPORT RD, LAKEWOOD, NJ 08701-5968
(732) 367-8859
(732) 367-8242
Mailing address
PO BOX 2036, LAKEWOOD, NJ 08701-8036
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0029807
—
NJ
Enumeration date
08/09/2022
Last updated
08/09/2022
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