Provider Demographics
NPI:1346335858
Name:GENE W. MANZETTI, M.D, P.C.
Entity Type:Organization
Organization Name:GENE W. MANZETTI, M.D, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GENE
Authorized Official - Middle Name:W
Authorized Official - Last Name:MANZETTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-469-2700
Mailing Address - Street 1:850 CLAIRTON BLVD
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236
Mailing Address - Country:US
Mailing Address - Phone:412-469-2700
Mailing Address - Fax:412-466-7010
Practice Address - Street 1:850 CLAIRTON BLVD
Practice Address - Street 2:SUITE 2300
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236
Practice Address - Country:US
Practice Address - Phone:412-469-2700
Practice Address - Fax:412-466-7010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD015124E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB35495Medicare UPIN