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NPI Code Detail

MEDICARE: DR. ANGELA LYNN MANNING D.D.S

MEDICARE: DR. ANGELA LYNN MANNING D.D.S
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
11223G0001XGeneral Practice Dentistry052156NY

General Provider Information

NPI Number : 1558427310
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGELA LYNN MANNING D.D.S
Provider Business Mailing Address
First Line : 555 WESTCHESTER AVE
Second Line :
City : RYE BROOK
State : NY
Zip : 10573-2859
Country : US
Telephone Number : 914-305-6555
Fax Number : 914-967-2776
Provider Business Practice Location Address
First Line : 555 WESTCHESTER AVE
Second Line :
City : RYE BROOK
State : NY
Zip : 10573-2859
Country : US
Telephone Number : 914-305-6555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2006
Last Update Date : 08/18/2020

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