Doctor Name: | MR. MARCELLINO JOSEPH MANGANELLI |
NPI Number: | 1013346170 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CERTIFIED SOCIAL WOR |
License Number: | 37CA00100800 |
Business Practice Address: | 2009 Bacharach Blvd Atlantic City, NJ - 084013003 |
Business Phone Number: | 6093445714 |
Business Fax Number: | 6093450775 |
Mailing Address: | 2009 Bacharach Blvd, ATLANTIC CITY |
State: | NJ |
Postal Code: | 084013003 |
Phone Number: | 6093445714 |
Fax Number: | 6093450775 |
NPI Enumeration Date: | 11/08/2013 |
NPI Last Update Date: | 11/08/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 37CA00100800 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |