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General NPI Number Information
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NPI Number | 1154300317
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Entity Type | Individual
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Provider Name | EUGENE M MANNO DPM
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Gender | Male
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Dates
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Enumeration Date | 01/16/2006
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Last Update Date | 03/15/2013
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Provider Practice Location Address
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Address Line | 1685 NEWBRIDGE RD
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City | NORTH BELLMORE
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State | NY
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Zip | 11710-1603
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Country | US
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Telephone | 516-828-0103
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Fax |
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Provider Business Mailing Address
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Address Line | 555 NORTH AVE 15V
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City | FORT LEE
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State | NJ
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Zip | 07024-2404
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Country | US
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Telephone | 201-783-2618
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Fax |
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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 | 25MD00113300
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License Number State | NJ
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