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Individual

MICHAEL MANGINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
C.P.O., C.PED.

Contact information

Practice address
616 E JERICHO TPKE, HUNTINGTON STATION, NY 11746-7317
(631) 271-0825
Mailing address
16 BEAUMONT DR, MELVILLE, NY 11747-3402
(631) 271-0825

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
224L00000X
Pedorthist
224P00000X
Prosthetist

Other

Enumeration date
11/23/2010
Last updated
11/23/2010
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