Doctor Name: | DEBORAH MANCE |
NPI Number: | 1194818492 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | F332296 |
Business Practice Address: | 532 Blooming Grove Tpke New Windsor, NY - 125537846 |
Business Phone Number: | 8455627800 |
Business Fax Number: | 8455620213 |
Mailing Address: | 886 Oregon Trl, PINE BUSH |
State: | NY |
Postal Code: | 125665319 |
Phone Number: | 8457442903 |
Fax Number: | 8457448262 |
NPI Enumeration Date: | 10/02/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | F332296 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |