Provider Demographics
NPI:1003345232
Name:MARC MANZIONE MD LLC
Entity type:Organization
Organization Name:MARC MANZIONE MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:MANZIONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-366-5112
Mailing Address - Street 1:PO BOX 349
Mailing Address - Street 2:
Mailing Address - City:ORWIGSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17961-0349
Mailing Address - Country:US
Mailing Address - Phone:570-366-5112
Mailing Address - Fax:
Practice Address - Street 1:2600 PHILMONT AVE STE 119
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-5307
Practice Address - Country:US
Practice Address - Phone:570-366-5112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-10
Last Update Date:2017-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty