Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 283380 | NY |
NPI | 1154442432 |
---|---|
Provider Name | Dr. Patrick William Mannal |
First Address | Cooperstown, NY 13326-1001 |
Second Address | Milford, NY 13807-1147 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 02/08/2016 |