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NPI Code Detail

MEDICARE: ANDREW J MANGANO PT

MEDICARE: ANDREW J MANGANO PT
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
1225100000XPhysical TherapistPT5727OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PT05727OTHEROHOHIO OT PT ATC BOARD

General Provider Information

NPI Number : 1346230919
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW J MANGANO PT
Provider Business Mailing Address
First Line : 746 E AURORA RD
Second Line : SUITE 7
City : MACEDONIA
State : OH
Zip : 44056-2732
Country : US
Telephone Number : 330-908-0039
Fax Number : 330-908-0211
Provider Business Practice Location Address
First Line : 746 E AURORA RD
Second Line : SUITE 7
City : MACEDONIA
State : OH
Zip : 44056-2732
Country : US
Telephone Number : 330-908-0039
Fax Number : 330-908-0211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2005
Last Update Date : 03/26/2013

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Directions to “ ANDREW J MANGANO PT” Practice Location

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