Provider Demographics
NPI:1538481015
Name:MANGIARACINA, ANTHONY CHARLES (RPH)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:CHARLES
Last Name:MANGIARACINA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:973 MCLEAN AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-4108
Mailing Address - Country:US
Mailing Address - Phone:914-237-8821
Mailing Address - Fax:914-237-0716
Practice Address - Street 1:973 MCLEAN AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-4108
Practice Address - Country:US
Practice Address - Phone:914-237-8821
Practice Address - Fax:914-237-0716
Is Sole Proprietor?:No
Enumeration Date:2010-02-24
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist