Healthcare Provider Details

I. General information

NPI: 1740223205
Provider Name (Legal Business Name): ARTHUR GREGORY MANNING DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 01/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 UNION ST
ELLSWORTH ME
04605-1534
US

IV. Provider business mailing address

230 RIVERSIDE DR #8-O
NEW YORK NY
10025-6105
US

V. Phone/Fax

Practice location:
  • Phone: 207-664-5311
  • Fax:
Mailing address:
  • Phone: 917-238-0918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number1419
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number240810
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: