Manzo, Mary Moon

Manzo, Mary Moon is an sole proprietor health care provider with primary practice located at 19 Friendship St , Newport RI 02840-2272. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Manzo, Mary Moon can be contacted via phone (401) 849-6868.

Contact Information

Primary practice address
19 Friendship St Newport RI 02840-2272
Phone: (401) 849-6868
Fax: (401) 847-3840
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA 449 Rhode Island

Profile Details

NPI number 1730292244
LBN Legal business name Manzo, Mary Moon
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 17th, 2006
Last updated Feb 16th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730292244 NPPES
Rhode Island Other PA 449 RI LICENSE
Rhode Island Other 414659 RI LICENSE
Rhode Island Other 33279 RI LICENSE

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