Individual
EMELINE M MANDEVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM
Contact information
Practice address
301 W STATE ST, ITHACA, NY 14850-5431
(607) 288-2336
(607) 304-5534
Mailing address
301 W STATE ST, ITHACA, NY 14850-5431
(607) 288-2336
(607) 304-5534
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
28 001693
NY
Other
Enumeration date
12/04/2012
Last updated
03/28/2023
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