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General NPI Number Information
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NPI Number | 1033196670
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Entity Type | Individual
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Provider Name | WARREN BRUCE MANGEL D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 12/25/2005
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Last Update Date | 10/21/2020
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Provider Practice Location Address
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Address Line | 805 COOPER RD STE 4
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City | VOORHEES
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State | NJ
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Zip | 08043-3814
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Country | US
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Telephone | 856-479-9430
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Fax | 856-281-9102
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Provider Business Mailing Address
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Address Line | 2000 CRAWFORD PL STE 200
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City | MOUNT LAUREL
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State | NJ
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Zip | 08054-3954
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Country | US
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Telephone | 856-355-0340
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Fax | 856-355-0330
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 25MD00145500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 25MD00145500
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License Number State | NJ
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