| Alexis Jacklyn Manzella, | |
|
25 Libby St, Brockton, MA 02302-2949 | |
| (508) 941-7700 | |
| Not Available |
| Full Name | Alexis Jacklyn Manzella |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 2 Years |
| Location | 25 Libby St, Brockton, Massachusetts |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083461248 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | RN2377937 (Massachusetts) | Secondary |
| 163WM0705X | Registered Nurse - Medical-surgical | RN2377937 (Massachusetts) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Signature Healthcare Brockton Hospital | Brockton, MA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Signature Healthcare Medical Group Inc | 7719876267 | 250 |
| Entity Name | Atrius Health Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871639914 PECOS PAC ID: 4789588641 Enrollment ID: O20031121000582 |
| Entity Name | Signature Healthcare Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508804949 PECOS PAC ID: 7719876267 Enrollment ID: O20040312000372 |
| Entity Name | Engrace Behavioral Health Services LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013416387 PECOS PAC ID: 7214292069 Enrollment ID: O20180525000621 |
| Mailing Address | Practice Location Address |
|---|---|
| Alexis Jacklyn Manzella, 28 Concord St Apt 3, Boston, MA 02129-2571 Ph: Not Available | Alexis Jacklyn Manzella, 25 Libby St, Brockton, MA 02302-2949 Ph: (508) 941-7700 |
Marie A Colas, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 93 Ford St, Brockton, MA 02301 Phone: 508-580-6546 |
Lucy J Villegas, NP Registered Nurse Medicare: Accepting Medicare Assignments Practice Location: 940 Belmont St Bldg 4, Brockton, MA 02301 Phone: 774-826-1842 Fax: 774-826-1153 |
Mrs. Robin Parente, R.N. Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 940 Belmont St, Brockton, MA 02301 Phone: 774-826-1194 |
Janina Marie Colavita, NP Registered Nurse Medicare: Accepting Medicare Assignments Practice Location: 63 Main St, Brockton, MA 02301 Phone: 508-894-3473 |
Joseph Omwata, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 26 Madrid Sq Apt 11, Brockton, MA 02301 Phone: 857-615-0410 |
Crystal Hunter, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 180 Centre St, Brockton, MA 02302 Phone: 508-586-6300 |
Jacqueline Spencer, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 63 Main St, Brockton, MA 02301 Phone: 508-559-6699 Fax: 508-559-5073 |