Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | DPM00204 | RI |
NPI | 1023132099 |
---|---|
Provider Name | Dr. Melvin J Mancini |
First Address | Pawtucket, RI 02861-2429 |
Second Address | Pawtucket, RI 02861-2429 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2007 |
Last Update Date | 13/05/2009 |