Organization
SHORELINE NEPHROLOGY ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK J MANCINI MD (VICE PRESIDENT)
(401) 596-3313
Entity
Organization
Contact information
Practice address
17 WELLS ST, SUITE 202, WESTERLY, RI 02891-2923
(401) 596-3313
(401) 596-2650
Mailing address
17 WELLS ST, SUITE 202, WESTERLY, RI 02891-2923
(401) 596-3313
(401) 596-2650
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7002051
—
RI
Enumeration date
10/20/2006
Last updated
05/19/2008
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