MEDICARE: DR. MARIE LOUISE MANNINO 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	207R00000X	Internal Medicine Physician	25MA04197906	NJ

General Provider Information

NPI Number	:	1790022556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIE LOUISE MANNINO M.D.

Provider Business Mailing Address
First Line	:	91 MOUNTAIN AVE
Second Line	:
City	:	HAWTHORNE
State	:	NJ
Zip	:	07506-3331
Country	:	US
Telephone Number	:	973-423-3534
Fax Number	:

Provider Business Practice Location Address
First Line	:	91 MOUNTAIN AVE
Second Line	:
City	:	HAWTHORNE
State	:	NJ
Zip	:	07506-3331
Country	:	US
Telephone Number	:	973-423-3534
Fax Number	:

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

Provider Enumeration Date	:	01/13/2013
Last Update Date	:	01/13/2013

Similar Medicare Providers

1376546218 — MS. SHELLEY C STEINBERG MSW, LCSW, LMFT
Practice Location Address:

35 MOUNTAIN AVE
HAWTHORNE, NJ
07506-3331

Practice Phone: 973-427-7867
Practice Fax: 973-427-1862

1912958521 — DR. SURENDRA P GOEL M.D.
Practice Location Address:

159 MOUNTAIN AVE
HAWTHORNE, NJ
07506-3331

Practice Phone: 973-557-6731
Practice Fax:

1982656518 — DR. VIJAY GOEL M.D.
Practice Location Address:

159 MOUNTAIN AVE
HAWTHORNE, NJ
07506-3331

Practice Phone: 973-557-6731
Practice Fax:

1902414915 — KATALYST PERFORMANCE AND REHABILITATION LLC
Practice Location Address:

41 MOUNTAIN AVE
HAWTHORNE, NJ
07506-3331

Practice Phone: 973-513-2120
Practice Fax:

1952304008 — WILPAGE INC.
Practice Location Address:

146 GENEVIEVE AVE
HAWTHORNE, NJ
07506-2332

Practice Phone: 973-423-4100
Practice Fax: 973-423-0715

1053316539 — MRS. KUSUM L KANSAL RD,CDE
Practice Location Address:

332 LAFAYETTE AVE
HAWTHORNE, NJ
07506-2506

Practice Phone: 973-460-7560
Practice Fax: 862-239-6059

Directions to “ DR. MARIE LOUISE MANNINO M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.