Individual
DR. MARIO ANIBAL MANCHENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
422 GRAND STREET, HOBOKEN, NJ 07030
(201) 656-8743
(201) 319-0867
Mailing address
422 GRAND STREET, HOBOKEN, NJ 07030
(201) 656-8743
(201) 319-0867
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25MA03336800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3939707
—
NJ
Enumeration date
10/03/2006
Last updated
07/08/2007
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