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Search › New Jersey › 101Y00000X

Imelda Mantilla, BA

NPI 1720598204 · on the registry since 2017 · sole proprietor

Practice

Address
777 Bloomfield Ave
Clifton, NJ 07012
Phone
(973) 594-0125
Fax
(973) 594-0536
Organisation at this address
Rapps Pharmacy North, Llc
Serv Behavioral Health System
Serv Behavioral Health Systems
Serv Behavioral Health Systems
Serv Centers Of New Jersey, Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
47

Registry record

Primary taxonomy
101Y00000X
101Y00000X
Licence states on file
NJ
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2017-10-10

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New Jersey