MEDICARE: TERESA A. MANNING D.P.M

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	SC 003902 R	PA

General Provider Information

NPI Number	:	1093886566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA A. MANNING D.P.M

Provider Business Mailing Address
First Line	:	3333 5TH AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-3109
Country	:	US
Telephone Number	:	412-537-4756
Fax Number	:	412-673-0022

Provider Business Practice Location Address
First Line	:	1601 LINCOLN WAY
Second Line	:
City	:	WHITE OAK
State	:	PA
Zip	:	15131-1720
Country	:	US
Telephone Number	:	412-673-9222
Fax Number	:	412-673-0022

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	11/29/2011

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