Basic Information
| Provider Information | |||||||||
| NPI: | 1902275696 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MANNELLINO | ||||||||
| FirstName: | MARGARET | ||||||||
| MiddleName: | ERIN | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 ELMWOOD AVE BOX 629 | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146421152 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 60 GREECE CENTER DR | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146421152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5857239100 | ||||||||
| FaxNumber: | 5857581299 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2015 | ||||||||
| LastUpdateDate: | 05/30/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 22 673870 | NY | N | Nursing Service Providers | Registered Nurse | 207Y00000X | F344411-1 | NY | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.