Provider Demographics
NPI:1457989568
Name:MANZI, MADISON MEYER (MD)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:MEYER
Last Name:MANZI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:TAYLOR
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:111 MADISON AVENUE #308
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960
Mailing Address - Country:US
Mailing Address - Phone:973-285-0400
Mailing Address - Fax:
Practice Address - Street 1:111 MADISON AVENUE #308
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960
Practice Address - Country:US
Practice Address - Phone:973-285-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MA12253800207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program