Organization
MANZELLA FAMILY HEALTHCARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR A MANZELLA MD (OWNER)
(570) 325-8393
Entity
Organization
Contact information
Practice address
1353 STATE ROUTE 903, JIM THORPE, PA 18229-2734
(570) 325-8393
(570) 325-8029
Mailing address
1353 STATE ROUTE 903, JIM THORPE, PA 18229-2734
(570) 325-8393
(570) 325-8029
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1753980
BLUE CROSS/ BLUE SHIELD
PA
01
—
50056259
CAPITAL BLUE CROSS
PA
Enumeration date
12/22/2005
Last updated
04/04/2013
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