Provider Demographics
NPI:1750524526
Name:MANCINI, CARMELA (DO, MPH)
Entity type:Individual
Prefix:MS
First Name:CARMELA
Middle Name:
Last Name:MANCINI
Suffix:
Gender:F
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-3548
Mailing Address - Country:US
Mailing Address - Phone:727-364-6968
Mailing Address - Fax:
Practice Address - Street 1:123 PLEASANT ST STE 105
Practice Address - Street 2:
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945-2380
Practice Address - Country:US
Practice Address - Phone:781-780-2461
Practice Address - Fax:781-990-3467
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-09
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251116207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine