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General NPI Number Information
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NPI Number | 1912950346
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Entity Type | Individual
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Provider Name | MELINDA MARIE MANGANELLO PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 655 MAIN ST S
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City | SOUTHBURY
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State | CT
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Zip | 06488-4220
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Country | US
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Telephone | 877-407-3422
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Fax | 877-407-4329
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Provider Business Mailing Address
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Address Line | 254B MOUNTAIN AVE, STE 201 NJ SPORT & SPINE
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City | HACKETTSTOWN
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State | NJ
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Zip | 07840
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Country | US
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Telephone | 908-684-5800
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Fax | 908-684-5606
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 17337
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01291000
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License Number State | NJ
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