Provider Demographics
NPI:1063910206
Name:MANCINI, JOSEPHINE
Entity type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:
Last Name:MANCINI
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JOSEPHINE
Other - Middle Name:
Other - Last Name:D'AMATO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1935 E 18TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3409
Mailing Address - Country:US
Mailing Address - Phone:718-419-6668
Mailing Address - Fax:
Practice Address - Street 1:1935 E 18TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3409
Practice Address - Country:US
Practice Address - Phone:718-419-6668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist