Provider Demographics
NPI:1003084195
Name:MANETTA, CHRISTOPHER (DO)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:MANETTA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08007-0159
Mailing Address - Country:US
Mailing Address - Phone:888-982-8594
Mailing Address - Fax:888-982-8594
Practice Address - Street 1:1000 CRAWFORD PL
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-3932
Practice Address - Country:US
Practice Address - Phone:888-982-8594
Practice Address - Fax:888-982-8594
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NMA-1807-142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program