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Individual
MR. VICTOR A MANZELLA
Active
Individual
MR. VICTOR A MANZELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD063778L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010044500
BLACK LUNG
—
01
—
03180401
CAPITAL BLUE CROSS
—
01
—
034162
BLUE SHIELD
PA
01
—
034162
AMERIHEALTH ADMIN
—
01
—
0444184000
PERSONAL BLUE SHIELD
—
01
—
1753980
FEDERAL BLUE SHIELD
—
01
—
20031256
AMERIHEALTH MERCY
—
01
—
2598929
GHI
—
01
—
5389099
AETNA
—
01
—
P00416365
PALMETTO GBA GROUP
—
Enumeration date
12/06/2005
Last updated
03/29/2023
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