Doctor Name: | CLIFFORD G MANCINE |
NPI Number: | 1376615435 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | NJ1048 |
Business Practice Address: | 2910 Route 130 Delran, NJ - 080752522 |
Business Phone Number: | 8567640200 |
Business Fax Number: | 8567641414 |
Mailing Address: | 2910 Route 130, DELRAN |
State: | NJ |
Postal Code: | 080752522 |
Phone Number: | 8567640200 |
Fax Number: | 8567641414 |
NPI Enumeration Date: | 11/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | NJ1048 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |