Provider Demographics
NPI:1629144951
Name:MANZELLA, JOHN BATTISTA (CA, MSTOM, DIPLOM)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:BATTISTA
Last Name:MANZELLA
Suffix:
Gender:M
Credentials:CA, MSTOM, DIPLOM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:102 E BAY AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-3175
Mailing Address - Country:US
Mailing Address - Phone:609-276-7560
Mailing Address - Fax:609-978-1610
Practice Address - Street 1:102 E BAY AVE
Practice Address - Street 2:SUITE C
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-3175
Practice Address - Country:US
Practice Address - Phone:609-978-1428
Practice Address - Fax:609-978-1610
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2024-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00025000171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist