Individual
BARBARA MANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
RCWATC, 117 SEWARD AVE, SUITE 12-16, MIDDLETOWN, NY 10940
(845) 341-2543
Mailing address
146 PIKE STREET, PORT JERVIS, NY 12771
(845) 858-1456
(845) 858-1459
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
320528-1
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F304044-1
NY
Other
Enumeration date
08/31/2005
Last updated
10/20/2008
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