Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 25MA03313400 | NJ |
NPI | 1053364364 |
---|---|
Provider Name | Dr. Frank P Manginello |
First Address | Saddle River, NJ 07458-3303 |
Second Address | Ridgewood, NJ 07450-2726 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1423908 | (05) | NJ |
C56271 | (02) |