Organization
COASTAL BACK AND PAIN INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS MANGANELLI MD (OWNER)
(732) 747-7077
Entity
Organization
Contact information
Practice address
459 JACK MARTIN BLVD, BRICK, NJ 08724-7724
(732) 747-7077
Mailing address
PO BOX 297, MANASQUAN, NJ 08736-0297
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
01/13/2016
Last updated
01/13/2016
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