Active NPI
Nicole Mannino
- Specialist
- Wantagh, NY
National Provider Identifier
1124674817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 3680 Demott Ave
Wantagh, NY 11793-3524 - Phone
- (516) 849-2718
- NPI assigned
- Aug 17, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
3680 Demott Ave
Wantagh, NY 11793-3524
Mailing address
3680 Demott Ave
Wantagh, NY 11793-3524
Phone (516) 849-2718
Other practice location 1
3680 DeMott Ave
Wantagh, NY 11793-3524
Phone (516) 849-2718
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566000000000",
"number": "1124674817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3680 DEMOTT AVE",
"city": "WANTAGH",
"state": "NY",
"postal_code": "117933524",
"telephone_number": "516-849-2718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3680 DEMOTT AVE",
"city": "WANTAGH",
"state": "NY",
"postal_code": "117933524",
"telephone_number": "516-849-2718"
}
],
"practiceLocations": [
{
"address_1": "3680 DeMott Ave",
"address_purpose": "LOCATION",
"city": "Wantagh",
"state": "NY",
"postal_code": "117933524",
"country_code": "US",
"telephone_number": "516-849-2718",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANNINO",
"first_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-17",
"last_updated": "2019-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wantagh, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.