person
Mary Moon Manzo, PA-C
Surgical Physician Assistant in Newport, Rhode Island
NPI 1730292244

Mary Moon Manzo is a Surgical Physician Assistant based in Providence, RI and is specialized in Surgical. Mary Moon Manzo practices in Newport, RI and has the professional credentials of PA-C. The NPI Number for Mary Moon Manzo is 1730292244 and holds a License No. PA 449 (Rhode Island).

The current practice location address for Mary Moon Manzo is 19 Friendship St, Newport, RI and can be reached out via phone at 401-849-6868 and via fax at 401-847-3840. You can also correspond with Mary Moon Manzo through the mailing address at 2 DUDLEY ST, PROVIDENCE, RI - 02905-3248 (mailing address contact number: 401-849-6868).

Location: 19 Friendship St, Newport, RI, 02905-3248
person
Provider Profile Details
NPI Number
1730292244
Provider Name
Mary Moon Manzo
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
19 Friendship St, Newport, RI, 02905-3248
Phone Number
401-849-6868
Fax Number
401-847-3840
Provider Enumeration Date
08/17/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
PA 449 01 RI RI LICENSE
414659 01 RI BLUE CHIP
33279 01 RI BS
institution
Provider Business Practice Location Address Details
Address
19 Friendship St
City
State
Zip
02840-2272
Phone Number
401-849-6868
Fax Number
401-847-3840
person
Provider Business Mailing Address Details
Address
19 Friendship St
City
State
Zip
02840-2272
Phone Number
401-849-6868
Fax Number
401-847-3840
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
PA 449 (Rhode Island)
Definition
Definition to come...
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