person
Dr. Charles M Manganiello, MD
General Practice Physician in Duryea, Pennsylvania
NPI 1861490310

Charles M Manganiello is a General Practice Physician based in Kingston, PA. Charles M Manganiello practices in Duryea, PA and has the professional credentials of MD. The NPI Number for Charles M Manganiello is 1861490310 and holds a License No. MD037791L (Pennsylvania).

The current practice location address for Charles M Manganiello is 605 Main St, Duryea, PA and can be reached out via phone at 570-457-1110.

Location: 605 Main St, Duryea, PA, 18704-0379
person
Provider Profile Details
NPI Number
1861490310
Provider Name
Charles M Manganiello
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
605 Main St, Duryea, PA, 18704-0379
Phone Number
570-457-1110
Fax Number
Provider Enumeration Date
07/08/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0013919460001 05 PA
001216 01 PA FIRST PRIORITY HEALTH
024946 01 PA FIRST PRIORITY LIFE INS C
020338000 01 PA BLACK LUNG
024946 01 PA HIGHMARK BLUE SHIELD
14821 E222 01 PA GEISINGER HEALTH PLAN
institution
Provider Business Practice Location Address Details
Address
605 Main St
City
State
Zip
18642-1325
Phone Number
570-457-1110
Fax Number
person
Provider Business Mailing Address Details
Address
605 Main St
City
State
Zip
18642-1325
Phone Number
570-457-1110
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
MD037791L (Pennsylvania)
Definition
Definition to come...
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