Provider Demographics
NPI:1083638464
Name:MANJONEY, VINCENT A JR (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:A
Last Name:MANJONEY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2720 MAIN ST
Mailing Address - Street 2:3RD FLOOR SOUTH
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-5308
Mailing Address - Country:US
Mailing Address - Phone:203-579-7500
Mailing Address - Fax:203-576-0035
Practice Address - Street 1:2720 MAIN ST
Practice Address - Street 2:3RD FLOOR SOUTH
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-5308
Practice Address - Country:US
Practice Address - Phone:203-579-7500
Practice Address - Fax:203-576-0035
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0230892086S0102X, 2086S0127X, 2086X0206X, 208C00000X, 2086S0105X, 208600000X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010023089CT05OtherBLUE CROSS
CT2213438OtherAETNA
CT0147427002OtherCIGNA
CT1422826OtherUNITED HEALTHCARE
CTZS911OtherOXFORD HEALTH
CT001603OtherHEALTHNET
CT020000468OtherMEDICARE PTAN
CTC001459OtherCHAMPUS/TRICARE
CT5450106OtherUS HEALTHCARE
CT001230895Medicaid
CT755210OtherCONNECTICARE
C64783Medicare UPIN