Individual
STEPHEN MANGANARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 ROE AVE, ELMIRA, NY 14905-1629
(607) 737-4508
(607) 735-5738
Mailing address
571 SAINT JOSEPHS BLVD FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
163186
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00925939
—
NY
Enumeration date
08/09/2006
Last updated
06/16/2016
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