Provider Demographics
NPI:1093886566
Name:MANNING, TERESA A (DPM)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:A
Last Name:MANNING
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3109
Mailing Address - Country:US
Mailing Address - Phone:412-537-4756
Mailing Address - Fax:412-673-0022
Practice Address - Street 1:1601 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:WHITE OAK
Practice Address - State:PA
Practice Address - Zip Code:15131-1720
Practice Address - Country:US
Practice Address - Phone:412-673-9222
Practice Address - Fax:412-673-0022
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC 003902 R213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA143653Medicare PIN