Organization
INNOVATIVE MEDICAL PARTNERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN F MANGONE DO (OWNER)
(215) 817-1799
Entity
Organization
Contact information
Practice address
701 UPPER BLVD, RIDGEWOOD, NJ 07450-1124
(215) 817-1799
Mailing address
30 N FRANKLIN TPKE, PO BOX # 3, HOHOKUS, NJ 07423-9998
(215) 817-1799
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
02/22/2022
Last updated
02/22/2022
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