Individual
ARTEMIO M MANANSALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 BREWSTER ST, PAWTUCKET, RI 02860-4400
(401) 729-2617
Mailing address
185 RYKOWSKI LN STE 101, MIDDLETOWN, NY 10941-4055
(845) 692-0030
(845) 692-0037
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
11622
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AM68894
MEDICARE PTAN
RI
Enumeration date
09/15/2006
Last updated
07/26/2021
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