Individual
JORGE L MANGUAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
601 ELMWOOD AVE, BOX 604, ROCHESTER, NY 14642-0001
(585) 275-5892
(585) 756-0169
Mailing address
601 ELMWOOD AVE, BOX 604, ROCHESTER, NY 14642-0001
(585) 275-5982
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
488210
NY
Other
Enumeration date
01/11/2007
Last updated
11/10/2007
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