Individual
MAX MANGANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14 TENNEY ST, GEORGETOWN, MA 01833-1710
(978) 852-5587
Mailing address
14 TENNEY ST, GEORGETOWN, MA 01833-1710
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2020
Last updated
05/12/2022
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