Provider Demographics
NPI:1376526301
Name:MCCONVILLE, MANZELLA, QUARTEY, SINGER PARTNERSHIP
Entity Type:Organization
Organization Name:MCCONVILLE, MANZELLA, QUARTEY, SINGER PARTNERSHIP
Other - Org Name:DIVISION OF INFECTIOUS DISEASE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF/PHYSICIAN-PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:MANZELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-851-2417
Mailing Address - Street 1:1001 S GEORGE ST
Mailing Address - Street 2:4TH FLOOR KETTERMAN BUILDING
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3676
Mailing Address - Country:US
Mailing Address - Phone:717-851-2417
Mailing Address - Fax:717-851-3712
Practice Address - Street 1:1001 S GEORGE ST
Practice Address - Street 2:4TH FLOOR KETTERMAN BUILDING
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3676
Practice Address - Country:US
Practice Address - Phone:717-851-2417
Practice Address - Fax:717-851-3712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006473960001Medicaid
066991Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER