Mandracchia, Vincent

Mandracchia, Vincent is an individual health care provider with primary practice located at 1801 Hickman Rd Broadlawns Medical Center, Des Moines IA 50314-1505. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Mandracchia, Vincent can be contacted via phone (515) 282-2319.

Contact Information

Primary practice address
1801 Hickman Rd Broadlawns Medical Center Des Moines IA 50314-1505
Phone: (515) 282-2319
Fax: (515) 282-3234
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 000581 Iowa

Profile Details

NPI number 1174518260
LBN Legal business name Mandracchia, Vincent
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2005
Last updated Dec 22nd, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174518260 NPPES
Iowa MEDICAID 1088146

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