Provider Demographics
NPI:1760404149
Name:MANIA, CARMEL-ANN (DC)
Entity Type:Individual
Prefix:
First Name:CARMEL-ANN
Middle Name:
Last Name:MANIA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 SUMMIT AVENUE
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1430
Mailing Address - Country:US
Mailing Address - Phone:201-525-0707
Mailing Address - Fax:201-525-0785
Practice Address - Street 1:344 SUMMIT AVENUE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1430
Practice Address - Country:US
Practice Address - Phone:201-525-0707
Practice Address - Fax:201-525-0785
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00178000111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1093908Medicaid
NJ222330671OtherBLUE CROSS/ BLUE SHIELD
NJ222330671OtherBLUE CROSS/ BLUE SHIELD
NJU33548Medicare UPIN