Active NPI
Michael Anthony Mancano, PHARMD
- Pharmacist
- Philadelphia, PA
National Provider Identifier
1770170789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP035397L
- Practice address
- 3307 N Broad St
Philadelphia, PA 19140-5101 - Phone
- (609) 634-1299
- NPI assigned
- Dec 23, 2020
- Last updated
- Dec 23, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI02141400 | NJ | |
| Pharmacist | 183500000X | PH1315 | HI | |
| Pharmacist | 183500000X | RP035397L | PA | Primary |
Addresses
Primary practice location
3307 N Broad St
Philadelphia, PA 19140-5101
Mailing address
6 Rockingham Dr
Marlton, NJ 08053-4414
Phone (609) 634-1299
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | mmancano@temple.edu | Direct |
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH1315 | HI | MD | Pharmacist |
| 28RI02141400 | NJ | MD | Pharmacist |
| RP035397L | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608681600000",
"number": "1770170789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 ROCKINGHAM DR",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080534414",
"telephone_number": "609-634-1299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3307 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191405101",
"telephone_number": "609-634-1299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANCANO",
"first_name": "MICHAEL",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-23",
"last_updated": "2020-12-23",
"certification_date": "2020-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI02141400",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "HI",
"license": "PH1315",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP035397L",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "mmancano@temple.edu",
"affiliation": "N",
"endpointDescription": "Work email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3307 N Broad St",
"city": "Philadelphia",
"state": "PA",
"country_code": "US",
"postal_code": "191405101",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.