Individual
VIRGILIO MANGONON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
525 JACK MARTIN BLVD, SUITE 300, BRICK, NJ 08724-7737
(732) 840-0067
Mailing address
138 W 56TH ST, BAYONNE, NJ 07002-2210
(201) 487-7227
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MA39916
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0471003
—
NJ
Enumeration date
10/18/2005
Last updated
02/15/2011
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