IndividualActive
Micaela Manganello
NPI 1063384907 · Addiction Medicine (Preventive Medicine) Physician · South Portland, ME
Provider details
- NPI number
- 1063384907
- Entity type
- Individual
- Primary specialty
- Addiction Medicine (Preventive Medicine) PhysicianAllopathic & Osteopathic Physicians
- Sex
- Female
- Sole proprietor
- No
- License
- RN72898 (ME)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
400 Western Ave
South Portland, ME 04106-1704
Phone: (207) 292-1306
Approximate (ZIP-level) locationGet directions
Mailing address
50 Adams St Apt 1
Biddeford, ME 04005-2995
Registry dates
- Enumerated
- 2025-09-20
- Last updated
- 2025-09-20
- Certified
- 2025-09-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.