Provider Demographics
NPI:1326470089
Name:MANCINI, NYDIA (PHARMD)
Entity Type:Individual
Prefix:
First Name:NYDIA
Middle Name:
Last Name:MANCINI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 NC 24-87
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:NC
Mailing Address - Zip Code:28326-6954
Mailing Address - Country:US
Mailing Address - Phone:910-960-0250
Mailing Address - Fax:
Practice Address - Street 1:1025 NC 24-87
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:NC
Practice Address - Zip Code:28326-6954
Practice Address - Country:US
Practice Address - Phone:910-960-0250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23417183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist