Provider Demographics
NPI:1023413945
Name:MANCINI CONSULTING L.L.C.
Entity type:Organization
Organization Name:MANCINI CONSULTING L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:WIFE/OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZOE
Authorized Official - Middle Name:REBECCA
Authorized Official - Last Name:MANCINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1313-418-6001
Mailing Address - Street 1:19768 BEVERLY RD
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-3911
Mailing Address - Country:US
Mailing Address - Phone:131-341-8600
Mailing Address - Fax:124-879-2915
Practice Address - Street 1:2881 MONROE ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-3475
Practice Address - Country:US
Practice Address - Phone:131-356-2323
Practice Address - Fax:131-356-3333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL116354207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty