MEDICARE: DR. ANTHONY GERARD MANISCALCO 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	2084N0400X	Neurology Physician	140041	NY

General Provider Information

NPI Number	:	1659371144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY GERARD MANISCALCO M.D.

Provider Business Mailing Address
First Line	:	117 70TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-1113
Country	:	US
Telephone Number	:	718-836-8800
Fax Number	:	718-836-0144

Provider Business Practice Location Address
First Line	:	117 70TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-1113
Country	:	US
Telephone Number	:	718-836-8800
Fax Number	:	718-836-0144

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

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	01/14/2015

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