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General NPI Number Information
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NPI Number | 1861511214
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Entity Type | Individual
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Provider Name | GINGER L MANZO M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2 WAKE ROBIN RD UNIT 206
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City | LINCOLN
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State | RI
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Zip | 02865-4241
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Country | US
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Telephone | 401-475-7610
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Fax | 401-475-2473
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Provider Business Mailing Address
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Address Line | 2 WAKE ROBIN RD UNIT 206
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City | LINCOLN
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State | RI
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Zip | 02865-4241
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Country | US
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Telephone | 401-475-7610
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Fax | 401-475-2473
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD09844
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License Number State | RI
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