Provider Demographics
NPI:1689845661
Name:RONALD MANONI DC PC
Entity Type:Organization
Organization Name:RONALD MANONI DC PC
Other - Org Name:MANONI CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:G
Authorized Official - Last Name:MANONI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-792-9582
Mailing Address - Street 1:8 LOCUST AVE
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6147
Mailing Address - Country:US
Mailing Address - Phone:203-792-9582
Mailing Address - Fax:203-792-2091
Practice Address - Street 1:8 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6147
Practice Address - Country:US
Practice Address - Phone:203-792-9582
Practice Address - Fax:203-792-2091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT326111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT350000245Medicare PIN