Provider Demographics
NPI:1669546495
Name:MANGIONE PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:MANGIONE PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:MANGIONE
Authorized Official - Suffix:
Authorized Official - Credentials:PT OWNER
Authorized Official - Phone:215-343-9400
Mailing Address - Street 1:1243 EASTON RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-3801
Mailing Address - Country:US
Mailing Address - Phone:215-343-9400
Mailing Address - Fax:215-343-4401
Practice Address - Street 1:1243 EASTON RD
Practice Address - Street 2:SUITE 104
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-3801
Practice Address - Country:US
Practice Address - Phone:215-343-9400
Practice Address - Fax:215-343-4401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADAPT000136225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2133068000OtherDC
PA143907OtherRS
PA603412800OtherUS DEPT OF LABOR
PA603412800OtherUS DEPT OF LABOR
PA=========OtherAMERIHEALTH