Individual
THOMAS MANGIARACINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
170 TAYLOR ROAD, BOX 115, MOUNTAINVILLE, NY 10953-0115
(845) 551-0140
(845) 534-4229
Mailing address
PO BOX 115, MOUNTAINVILLE, NY 10953-0115
(845) 551-0140
(845) 534-4229
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
124929
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00513662
—
NY
01
—
290009841
RR MEDICARE PROVIDER ID
NY
01
—
CE9235
RR MEDICARE
NY
Enumeration date
10/02/2006
Last updated
05/27/2015
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