Individual provider Active NPI

Clifford G Mancine

  • Optician
  • Delran, NJ
National Provider Identifier
1376615435
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
NJ1048 Issued in NJ
Practice address
2910 Route 130
Delran, NJ 08075-2522
Phone
(856) 764-0200
Fax
(856) 764-1414
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X NJ1048 NJ Primary

Addresses

Primary practice location

2910 Route 130
Delran, NJ 08075-2522

Mailing address

2910 Route 130
Delran, NJ 08075-2522
Phone (856) 764-0200

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

State licenses

LicenseStateTypeSpecialty
NJ1048NJMDOptician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376615435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 ROUTE 130",
            "city": "DELRAN",
            "state": "NJ",
            "postal_code": "080752522",
            "telephone_number": "856-764-0200",
            "fax_number": "856-764-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 ROUTE 130",
            "city": "DELRAN",
            "state": "NJ",
            "postal_code": "080752522",
            "telephone_number": "856-764-0200",
            "fax_number": "856-764-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCINE",
        "first_name": "CLIFFORD",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NJ",
            "license": "NJ1048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delran, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.