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Individual

JOHN PAUL MANNINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
725 ALBANY STREET, SHAPIRO 7, SUITE B, BOSTON, MA 02118
(617) 638-8456
(617) 638-8465
Mailing address
801 ALBANY STREET, FL GROUND, BOSTON, MA 02119

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN2288385
MA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN2288385
MA

Other

Enumeration date
07/17/2020
Last updated
11/01/2021
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