Individual
ENRICO S MANGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
290 E MAIN STREET, SUITE 700, SMITHTOWN, NY 11787
(631) 361-4802
(631) 361-5376
Mailing address
290 E MAIN STREET, SUITE 700, SMITHTOWN, NY 11787
(631) 361-4802
(631) 361-5376
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
131139
NY
Other
Enumeration date
11/02/2006
Last updated
11/12/2010
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