Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | MD035406E | PA |
NPI | 1023109410 |
---|---|
Provider Name | Anthony P Mannarino |
First Address | Bristol, PA 19007-4809 |
Second Address | Bristol, PA 19007-4809 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 13/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001035889 | (05) | PA |
B33607 | (02) |