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NPI Code Detail

MEDICARE: DR. WILBERT B MANIEGO MD

MEDICARE: DR. WILBERT B MANIEGO 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
1207R00000XInternal Medicine Physician221557NY

Other Identifiers

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

General Provider Information

NPI Number : 1356392427
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILBERT B MANIEGO MD
Provider Business Mailing Address
First Line : 915 HILLSIDE AVE
Second Line :
City : NEW HYDE PARK
State : NY
Zip : 11040-2529
Country : US
Telephone Number : 718-343-7600
Fax Number : 718-343-7603
Provider Business Practice Location Address
First Line : 915 HILLSIDE AVE
Second Line :
City : NEW HYDE PARK
State : NY
Zip : 11040-2529
Country : US
Telephone Number : 718-343-7600
Fax Number : 718-343-7603
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2006
Last Update Date : 09/06/2012

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