Individual
CHARLES MANGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1101 ERIE BLVD E, STE 210, SYRACUSE, NY 13210-1144
(315) 218-7591
Mailing address
1101 ERIE BLVD E STE 210, SYRACUSE, NY 13210-1184
(315) 218-7591
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
106955
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00550014
—
NY
Enumeration date
05/31/2005
Last updated
01/05/2017
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