Jamie Mangini

Individual provider Active NPI Physical Therapist · Fairmount City, PA

NPI 1285089870 · NPPES record last updated Mar 10, 2017

Key facts

NPI
1285089870
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT025024 (PA)
Practice address
987 Brookville St
Fairmount City, PA 16224-0046
Phone
(814) 275-1000
NPI assigned
May 2, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
041422NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dubois Regional Medical Center Past
since Jun 10, 2016
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT025024 PA Yes

Addresses

Primary practice location

987 Brookville St
Fairmount City, PA 16224-0046

Mailing address

15 S Main St
Ste 220
Jamestown, NY 14701-6626
Phone (716) 488-2322

Other identifiers

IdentifierTypeStateIssuer
65OtherPAMEDICARE B SPECIALTY CODE

Other providers in Fairmount City, PA

All providers in Fairmount City, PA · Physical Therapist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.