MEDICARE: JOSEPH A MANZI 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	213ES0131X	Foot Surgery Podiatrist	N003632-1	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1129470001	OTHER	NY	DME MEDICARE
3	480003192	OTHER	NY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417954462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH A MANZI D.P.M.

Provider Business Mailing Address
First Line	:	261 DELAWARE AVE
Second Line	:
City	:	DELMAR
State	:	NY
Zip	:	12054-1124
Country	:	US
Telephone Number	:	518-439-0423
Fax Number	:	518-478-9044

Provider Business Practice Location Address
First Line	:	261 DELAWARE AVE
Second Line	:
City	:	DELMAR
State	:	NY
Zip	:	12054-1124
Country	:	US
Telephone Number	:	518-439-0423
Fax Number	:	518-478-9044

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

Provider Enumeration Date	:	07/06/2005
Last Update Date	:	12/22/2014

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