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NPI Code Detail

MEDICARE: MR. BIREN MANGANI M.D.

MEDICARE: MR. BIREN MANGANI 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
1207R00000XInternal Medicine PhysicianMD465938PA

General Provider Information

NPI Number : 1518353796
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BIREN MANGANI M.D.
Provider Business Mailing Address
First Line : 801 OSTRUM ST
Second Line :
City : BETHLEHEM
State : PA
Zip : 18015-1000
Country : US
Telephone Number : 484-526-6643
Fax Number :
Provider Business Practice Location Address
First Line : 100 ST LUKES LN
Second Line :
City : STROUDSBURG
State : PA
Zip : 18360-6217
Country : US
Telephone Number : 484-526-6643
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2015
Last Update Date : 05/10/2022

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