Individual
JON MANIACI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3401 CIVIC CENTER BLVD, DIVISION OF PEDIATRIC PULMONOLOGY, PHILADELPHIA, PA 19104
(267) 425-2959
Mailing address
3401 CIVIC CENTER BLVD, DIVISION OF PEDIATRIC PULMONOLOGY, PHILADELPHIA, PA 19104
(267) 425-2959
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
MT220827
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
04/02/2017
Last updated
06/24/2020
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