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NPI Code Detail

MEDICARE: DR. EUGENE M MANNO DPM

MEDICARE: DR. EUGENE M MANNO DPM
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
1213E00000XPodiatrist25MD00113300NJ

General Provider Information

NPI Number : 1154300317
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EUGENE M MANNO DPM
Provider Business Mailing Address
First Line : 555 NORTH AVE
Second Line : 15V
City : FORT LEE
State : NJ
Zip : 07024-2404
Country : US
Telephone Number : 201-783-2618
Fax Number :
Provider Business Practice Location Address
First Line : 1685 NEWBRIDGE RD
Second Line :
City : NORTH BELLMORE
State : NY
Zip : 11710-1603
Country : US
Telephone Number : 516-828-0103
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2006
Last Update Date : 03/15/2013

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