MEDICARE: GENE W MANZETTI MD

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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	MD015124E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174515811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GENE W MANZETTI MD

Provider Business Mailing Address
First Line	:	850 CLAIRTON BLVD
Second Line	:	STE 2300
City	:	PITTSBURGH
State	:	PA
Zip	:	15236
Country	:	US
Telephone Number	:	412-469-2700
Fax Number	:	412-466-7010

Provider Business Practice Location Address
First Line	:	850 CLAIRTON BLVD
Second Line	:	STE 2300
City	:	PITTSBURGH
State	:	PA
Zip	:	15236
Country	:	US
Telephone Number	:	412-469-2700
Fax Number	:	412-466-7010

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	03/01/2010

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