Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | C1-0005647 | DE |
NPI | 1235173832 |
---|---|
Provider Name | Timothy A Manzone |
First Address | Wilmington, DE 19804-0012 |
Second Address | Newark, DE 19713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0001021201 | (05) | DE |
0193126000 | AMERIHEALTH PRODUCTS (01) | DE |
G28041 | (02) |