Individual
DR. RICHARD JOHN MANGANIELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
479 BUCKLAND RD, SOUTH WINDSOR, CT 06074-3739
(860) 644-5011
(860) 644-4833
Mailing address
479 BUCKLAND RD, SOUTH WINDSOR, CT 06074-3739
(860) 644-5011
(860) 644-4833
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
035387
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005955242
AETNA
CT
01
—
010035387CT01
BLUE CROSS
CT
01
—
035387
CONNECTICARE
CT
05
—
4216629
—
CT
01
—
OV8008
HEALTHNET
CT
01
—
P405022
OXFORD
CT
Enumeration date
02/17/2006
Last updated
07/08/2007
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