Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | MA041181 | NJ |
NPI | 1255451225 |
---|---|
Provider Name | Dr. Danilo Carlos Mangunay |
First Address | Green Brook, NJ 08812-2024 |
Second Address | Green Brook, NJ 08812-2024 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2007 |
Last Update Date | 08/07/2007 |