| Doctor Name: | MRS. AMY B MANGUAL |
| NPI Number: | 1184054371 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | REGISTERED NURSE |
| License Number: | 412073 |
| Business Practice Address: | 49 Lawrence Ave Potsdam, NY - 136761889 |
| Business Phone Number: | 3152652000 |
| Business Fax Number: | 3152655458 |
| Mailing Address: | 29 Leroy St, POTSDAM |
| State: | NY |
| Postal Code: | 136761787 |
| Phone Number: | 3152652000 |
| Fax Number: | |
| NPI Enumeration Date: | 11/25/2013 |
| NPI Last Update Date: | 11/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WS0200X |
| License Number: | 412073 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |