Provider Demographics
NPI:1215922828
Name:MANZIONE, MARC (MD)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:
Last Name:MANZIONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 WELSH RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-6357
Mailing Address - Country:US
Mailing Address - Phone:215-947-7550
Mailing Address - Fax:
Practice Address - Street 1:727 WELSH RD
Practice Address - Street 2:SUITE 103
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-6357
Practice Address - Country:US
Practice Address - Phone:215-947-7550
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022669E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
088991Medicare ID - Type Unspecified
C29470Medicare UPIN