MEDICARE: DR. DANIEL D MANZI M.D.

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	207RG0100X	Gastroenterology Physician	25MA03690300	NJ

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	:	1487636957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL D MANZI M.D.

Provider Business Mailing Address
First Line	:	799 BLOOMFIELD AVE STE 102
Second Line	:
City	:	VERONA
State	:	NJ
Zip	:	07044-1301
Country	:	US
Telephone Number	:	973-433-7600
Fax Number	:	973-433-7462

Provider Business Practice Location Address
First Line	:	799 BLOOMFIELD AVE STE 102
Second Line	:
City	:	VERONA
State	:	NJ
Zip	:	07044-1301
Country	:	US
Telephone Number	:	973-433-7600
Fax Number	:	973-433-7462

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

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	11/08/2017

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