Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 19955 | SC |
N | 208600000X | Surgeon | 19955 | SC |
Y | 208200000X | Surgeon | 25MA02159800 | NJ |
Y | 208600000X | Surgeon | 25MA02159800 | NJ |
NPI | 1003068115 |
---|---|
Provider Name | Victor Joseph Manuele |
First Address | Haddin Field, NJ 08033-3406 |
Second Address | Haddin Field, NJ 08033-3406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2008 |
Last Update Date | 21/10/2008 |