IndividualActive
Alicia Mamienski, CRNP
NPI 1962810069 · Pediatric Nurse Practitioner · Philadelphia, PA
Provider details
- NPI number
- 1962810069
- Entity type
- Individual
- Primary specialty
- Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CRNP
- Sex
- Female
- Sole proprietor
- No
- License
- SP013806 (PA)
Practice location
3400 Civic Center Blvd
Philadelphia, PA 19104-5127
Phone: (267) 425-4650
Mailing address
233 Golf Hills Rd
Havertown, PA 19083-1034
Registry dates
- Enumerated
- 2014-08-01
- Last updated
- 2014-08-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.