Individual
MR. JOHN R MANZELLA JR.
Active
Individual
MR. JOHN R MANZELLA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS010263L
PA
208000000X
Pediatrics Physician
OS010263L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001780247
—
PA
01
—
010054200
BLACK LUNG
—
01
—
0314295000
PERSONAL BLUE SHIELD
—
01
—
03197301
CAPITAL BLUE CROSS
—
01
—
1753980
FEDERAL BLUE SHIELD
—
01
—
176513
BLUE SHIELD
PA
01
—
176513
AMERIHEALTH ADMIN
—
01
—
20031252
AMERIHEALTH MERCY
—
01
—
2968846
GHI
—
01
—
5389099
AETNA
—
01
—
P00600418
PALMETTO
PA
Enumeration date
12/06/2005
Last updated
07/08/2008
Update your record
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