Individual
MRS. OLIVIA E. MANCILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
760 BROADWAY, WOODHULL MEDICAL & MENTAL HEALTH CENTER, BROOKLYN, NY 11206
(718) 963-8000
(718) 630-3122
Mailing address
199 LAWRENCE AVENUE, INWOOD, NY 11096
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
018327-1
NY
Other
Enumeration date
01/29/2015
Last updated
01/29/2015
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