Provider Demographics
NPI:1518289917
Name:MANNELLO, VIRGINIA ANGELA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:ANGELA
Last Name:MANNELLO
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 1:75 SHERWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562
Mailing Address - Country:US
Mailing Address - Phone:914-488-5245
Mailing Address - Fax:
Practice Address - Street 1:375 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:EASTCHESTER
Practice Address - State:NY
Practice Address - Zip Code:10709
Practice Address - Country:US
Practice Address - Phone:914-337-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051259-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist