Individual provider Active NPI

Marlee Angeline Mangino, PHARMD

  • Pharmacist
  • Albany, NY
National Provider Identifier
1912416322
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
063504 Issued in NY
Practice address
315 S Manning Blvd
Albany, NY 12208-1707
Phone
(518) 525-8010
NPI assigned
Sep 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 063504 NY Primary

Addresses

Primary practice location

315 S Manning Blvd
Albany, NY 12208-1707

Mailing address

24 Mann Blvd
Halfmoon, NY 12065-2620
Phone (518) 527-5480

Other practice location 1

155 Ballston Ave
Saratoga Springs, NY 12866-4715
Phone (518) 587-3050

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

LicenseStateTypeSpecialty
063504NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1912416322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 MANN BLVD",
            "city": "HALFMOON",
            "state": "NY",
            "postal_code": "120652620",
            "telephone_number": "518-527-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S MANNING BLVD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081707",
            "telephone_number": "518-525-8010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 Ballston Ave",
            "address_purpose": "LOCATION",
            "city": "Saratoga Springs",
            "state": "NY",
            "postal_code": "128664715",
            "country_code": "US",
            "telephone_number": "518-587-3050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGINO",
        "first_name": "MARLEE",
        "middle_name": "ANGELINE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "063504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.