Mary Moon Manzo is a Surgical in Providence, Rhode Island. Mary Moon Manzo practices all healthcare services and medical treatments related to Surgical. The NPI Number for Mary Moon Manzo is 1730292244. The last update date is 2012-02-16.
Mary Moon Manzo's current location address is 2 Dudley St, Providence, Rhode Island. You can contact this provider via phone number 4018496868 and fax number 4018473840. The mailing address for Mary Moon Manzo is 2 Dudley St, Providence, Rhode Island. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary Moon Manzo |
|---|---|
| Address | 2 Dudley St, Providence, Rhode Island |
| Phone Number | 4018496868 |
| Fax Number | 4018473840 |
| Sole Proprietor | Y |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1730292244 |
|---|---|
| Provider Enumeration Date | 2006-08-17 |
| Last Updated Date | 2012-02-16 |
Provider Mailing Address Detail
| Address | 2 Dudley St |
|---|---|
| City | Providence |
| State | Rhode Island (RI) |
| Post Code | 29053248 |
| Phone Number | 4018496868 |
| Fax Number | 4018473840 |
Provider's Primary Taxonomy Detail
| Speciality | Surgical |
|---|---|
| Taxonomy | 363As0400X |
| Licence No | PA 449 |
|
Definition: A licensed healthcare professional who assists in providing surgical care under physician supervision. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| PA 449 | RI | RI LICENSE | |
| 414659 | RI | BLUE CHIP | |
| 33279 | RI | BS |
Post Comment/ Review Below
What is the unique identifier code issued to Mary Moon Manzo by the Centers for Medicare & Medicaid Services?
The Mary Moon Manzo has been assigned the NPI (National Provider Identifier) 1730292244. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Mary Moon Manzo is physically located?
The Mary Moon Manzo is situated at the following address: 2 Dudley St, Providence, RI 29053248.
What is Mary Moon Manzo's specialized field of practice, and what is the corresponding taxonomy classification code?
The Mary Moon Manzo's area of specialization is Surgical, and the corresponding taxonomy code that categorizes this field of practice is 363As0400X.
On what date did the Mary Moon Manzo receive its 1730292244 assignment from the Centers for Medicare & Medicaid Services?
The Mary Moon Manzo was assigned its 1730292244 by the Centers for Medicare & Medicaid Services on 2006-08-17.
As of what date were the details pertaining to Mary Moon Manzo last refreshed?
The information related to the Mary Moon Manzo, including its address, specialty, and other relevant details, was last updated on 2012-02-16.