Individual
DR. ERICA LYNN MANCINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3000 HAMPTON CTR, SUITE A, MORGANTOWN, WV 26505-1708
(304) 598-2020
Mailing address
3000 HAMPTON CTR, SUITE A, MORGANTOWN, WV 26505-1708
(304) 598-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1052-OD
WV
152W00000X
Optometrist
5734
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810013688
—
WV
01
—
4283561
MEDICARE PTAN
WV
Enumeration date
08/09/2007
Last updated
06/03/2014
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