DR. CHARLES M MANGANIELLO (NPI# 1861490310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861490310 |
| Entity Type | Individual |
| Full Name | DR. CHARLES M MANGANIELLO |
| Credential | M.D. |
| Practice Address |
605 Main St Duryea PA 18642-1325 |
| Mailing Address |
Po Box 1388 Kingston PA 18704-0379 |
| Practice Telephone | 5704571110 |
| Mailing Telephone | 5702888881 |
| Mailing Fax Number | 5702888065 |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2020-03-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | MD037791L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | GEISINGER HEALTH PLAN | 14821 E222 | 01 |
| PA | 0013919460001 | 05 | |
| PA | HIGHMARK BLUE SHIELD | 024946 | 01 |
| PA | FIRST PRIORITY LIFE INS C | 024946 | 01 |
| PA | FIRST PRIORITY HEALTH | 001216 | 01 |
| PA | BLACK LUNG | 020338000 | 01 |
| Street Address |
605 MAIN ST |
| City | DURYEA |
| State | PA |
| Zip Code | 18642-1325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982196002 | Guy Michael Fasciana Md | Internal Medicine | 605 Main St, Duryea, PA 18642-1325 | 2018-06-04 |
| 1689689341 | Guy Michael Fasciana | Internal Medicine | 605 Main St, Duryea, PA 18642-1325 | 2006-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487124350 | Thomas John Karoscik | Pharmacist | 70 Phoenix Street, Duryea, PA 18642 | 2018-12-04 |
| 1821405929 | Rita Yuhas | Skilled Nursing Facility | 131 Mcalpine Street, Duryea, PA 18642 | 2014-07-21 |
| 1548293871 | Weis Markets Inc | Pharmacy | 70 Phoenix St, Duryea, PA 18642 | 2006-07-09 |
| 1154894079 | Richard Francis Bednar | Pharmacist | 70 Phoenix St, Duryea, PA 18642 | 2019-01-03 |
| 1689719361 | John A Fischer | Optometrist | 247 Main St, Duryea, PA 18642 | 2007-02-21 |
| 1508485418 | Family Prescription Ctr | Pharmacy | 335 Main St, Duryea, PA 18642-1026 | 2020-04-10 |
| 1053461418 | Family Prescription Ctr | Pharmacy | 335 Main St, Duryea, PA 18642-1026 | 2007-01-10 |
| 1356726566 | John Fischer, Od PC | Eyewear Supplier (Equipment, not the service) | 247 Main St, Duryea, PA 18642-1030 | 2015-07-29 |
| 1427158401 | Jeanne Santilli Hall | Optometrist | 247 Main St, Duryea, PA 18642-1030 | 2006-09-22 |
| 1336539964 | Lori Charney | Occupational Therapist | 95 Cranberry Ter, Duryea, PA 18642-1143 | 2015-02-03 |
| Find all providers in zip 18642 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1609494798 | Heather L Levan | General Practice | 919 Gravel Pike, Palm, PA 18070-1204 | 2020-07-06 |
| 1124642996 | Wound Pros Medical Group | General Practice | 1500 Market Street 12th Floor, East Tower, Philadelphia, PA 19102-2152 | 2020-06-08 |
| 1861024390 | Daniel James Leonard IIi | General Practice | 397 Fifth Street, Nanty Glo, PA 15943 | 2020-02-12 |
| 1831755735 | Good Hope Health Center Corp | General Practice | 7712 Buist Ave, Philadelphia, PA 19153-1705 | 2019-05-15 |
| 1366008260 | Ltc Treatment Center Inc | General Practice | 7712 Buist Ave Apt B, Philadelphia, PA 19153-1705 | 2019-05-15 |
| 1003479825 | Marsha Frances Santangelo | General Practice | 107 Sawgrass Drive, Blue Bell, PA 19422 | 2019-04-17 |
| 1972072288 | Paula Alejandra Pino Pommer | General Practice | 3551 North Broad St., Philadelphia, PA 19140-4160 | 2018-11-15 |
| 1033686159 | Star Wellness Center, Inc | General Practice | 511 E 3rd St Ste 202, Bethlehem, PA 18015-2180 | 2018-10-26 |
| 1891277620 | Donald C. Cameron | General Practice | 718 Kennett Pike, Chadds Ford, PA 19317 | 2018-08-29 |
| 1124510888 | Healing Place Medical, P.C. | General Practice | 1600 Horizon Dr Ste 122123, Chalfont, PA 18914-4100 | 2018-05-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.