Organization
LIFE LINE COMMUNITY HEALTHCARE NEW JERSEY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW MANGANARO MD (MEMBER)
(866) 964-3290
Entity
Organization
Contact information
Practice address
6111 OAK TREE BLVD STE 301, INDEPENDENCE, OH 44131-2585
(216) 581-6556
Mailing address
6111 OAK TREE BLVD STE 301, INDEPENDENCE, OH 44131-2585
(216) 581-6556
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/07/2014
Last updated
12/05/2025
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