Provider Demographics
NPI:1134672660
Name:MANNEY, ANTHONY J (PA-C, MS)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:J
Last Name:MANNEY
Suffix:
Gender:M
Credentials:PA-C, MS
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:409 S 2ND ST STE 2F
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1612
Mailing Address - Country:US
Mailing Address - Phone:717-724-6780
Mailing Address - Fax:717-724-6781
Practice Address - Street 1:25 SPRINT DR
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-7696
Practice Address - Country:US
Practice Address - Phone:717-960-3750
Practice Address - Fax:717-960-3734
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA058361363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA867633OtherMEDICARE GROUP #
PA1007307260063OtherDHS GROUP #
PA103193226Medicaid