MEDICARE: DR. CHRISTOPHER MANETTA D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	304398-01	NY
2	2084P0800X	Psychiatry Physician	OS019785	PA
3	390200000X	Student in an Organized Health Care Education/Training Program
4	2084P0800X	Psychiatry Physician	25MB10752900	NJ

General Provider Information

NPI Number	:	1003084195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER MANETTA D.O.

Provider Business Mailing Address
First Line	:	PO BOX 159
Second Line	:
City	:	BARRINGTON
State	:	NJ
Zip	:	08007-0159
Country	:	US
Telephone Number	:	888-982-8594
Fax Number	:	888-982-8594

Provider Business Practice Location Address
First Line	:	217 BLACK HORSE PIKE
Second Line	:
City	:	HADDON HEIGHTS
State	:	NJ
Zip	:	08035-1009
Country	:	US
Telephone Number	:	888-982-8594
Fax Number	:	888-920-1525

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2008
Last Update Date	:	09/04/2025

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