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NPI Code Detail

MEDICARE: MR. PAUL A MANNING

MEDICARE: MR. PAUL A MANNING
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1497919070
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PAUL A MANNING
Provider Business Mailing Address
First Line : 1695 MAIN ST FL 400
Second Line :
City : SPRINGFIELD
State : MA
Zip : 01103-1063
Country : US
Telephone Number : 413-739-5572
Fax Number :
Provider Business Practice Location Address
First Line : 1695 MAIN ST FL 400
Second Line :
City : SPRINGFIELD
State : MA
Zip : 01103-1063
Country : US
Telephone Number : 413-739-5572
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2008
Last Update Date : 02/11/2022

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