Organization
BONITA M MANCIA M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONITA M MANCIA M.D. (PHYSICIAN)
(570) 288-6521
Entity
Organization
Contact information
Practice address
676 WYOMING AVE, KINGSTON, PA 18704-3857
(570) 288-6521
Mailing address
676 WYOMING AVE, KINGSTON, PA 18704-3857
(570) 288-6521
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD022345E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013981600001
—
PA
Enumeration date
02/20/2008
Last updated
02/20/2008
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