Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 023089 | CT |
Y | 208600000X | Surgeon | 023089 | CT |
N | 2086S0102X | Surgical Critical Care | 023089 | CT |
N | 2086S0105X | Surgery of the Hand | 023089 | CT |
N | 2086S0127X | Trauma Surgeon | 023089 | CT |
N | 2086X0206X | Surgical Oncologist | 023089 | CT |
N | 208C00000X | Colorectal Surgeon | 023089 | CT |
NPI | 1083638464 |
---|---|
Provider Name | Dr. Vincent A Manjoney JR. |
First Address | Bridgeport, CT 06606-5308 |
Second Address | Bridgeport, CT 06606-5308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 01/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001230895 | (05) | CT |
001603 | HEALTHNET (01) | CT |
010023089CT05 | BLUE CROSS (01) | CT |
0147427002 | CIGNA (01) | CT |
020000468 | MEDICARE PTAN (01) | CT |
1422826 | UNITED HEALTHCARE (01) | CT |
2213438 | AETNA (01) | CT |
5450106 | US HEALTHCARE (01) | CT |
755210 | CONNECTICARE (01) | CT |
C001459 | CHAMPUS/TRICARE (01) | CT |
C64783 | (02) | |
ZS911 | OXFORD HEALTH (01) | CT |