Individual
MARY GRACE MANGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
220 E 42ND ST FL 6, NEW YORK, NY 10017-5831
(646) 416-3855
Mailing address
555 MAIN ST APT S304, NEW YORK, NY 10044-0307
(175) 758-0579
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
1555744
NY
Other
Enumeration date
01/25/2022
Last updated
01/25/2022
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