Provider Demographics
NPI:1265488282
Name:RALEIGH CARDIOLOGY ASSOCIATES, PA
Entity Type:Organization
Organization Name:RALEIGH CARDIOLOGY ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:MANGANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-231-6132
Mailing Address - Street 1:3000 NEW BERN AVE
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-1231
Mailing Address - Country:US
Mailing Address - Phone:919-231-6132
Mailing Address - Fax:919-231-6276
Practice Address - Street 1:3000 NEW BERN AVE
Practice Address - Street 2:SUITE 1200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1231
Practice Address - Country:US
Practice Address - Phone:919-231-6132
Practice Address - Fax:919-231-6276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8902536Medicaid
NC8902536Medicaid