MRS. ALICIA MAY MANCINI PA-C NPI 1356650006

NPI Information

NPI: 1356650006
Provider Name: MRS. ALICIA MAY MANCINI, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
4100 LAKE DR SE
SUITE 205
GRAND RAPIDS, MI
ZIP 49546
Phone: (616) 267-7100
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MRS. Alicia May Mancini, PA-C is a surgical physician assistant in Grand Rapids, MI. MRS. Alicia May Mancini, PA-C NPI is 1356650006. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4100 LAKE DR SE
SUITE 205
GRAND RAPIDS, MI
ZIP 49546-292
Phone: (616) 267-7100
Fax: (616) 267-7102

The NPI 1356650006 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/29/2010 and was last updated on 12/19/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	5601007930	MICHIGAN	Yes
2	363AS0400X	Physician Assistant	Surgical	002477	CONNECTICUT	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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