MEDICARE: THOMAS L. MANZO, M.D., P.C.

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	207W00000X	Ophthalmology Physician	MD-016446-E	PA

General Provider Information

NPI Number	:	1457426611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS L. MANZO, M.D., P.C.

Provider Business Mailing Address
First Line	:	1329 E HIGH ST
Second Line	:
City	:	POTTSTOWN
State	:	PA
Zip	:	19464-4949
Country	:	US
Telephone Number	:	610-326-4044
Fax Number	:	610-326-6901

Provider Business Practice Location Address
First Line	:	1329 E HIGH ST
Second Line	:
City	:	POTTSTOWN
State	:	PA
Zip	:	19464-4949
Country	:	US
Telephone Number	:	610-326-4044
Fax Number	:	610-326-6901

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THOMAS L. MANZO
Credential	:	M.D.
Telephone Number	:	610-326-4044

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	07/15/2010

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