Individual
GEOFFREY L MANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
385 MAIN ST SOUTH, UNION SQUARE, SOUTHBURY, CT 06488
(203) 264-7999
(203) 264-7477
Mailing address
385 MAIN ST SOUTH, UNION SQUARE BLDG #1, NVRA IMAGING NETWORK, SOUTHBURY, CT 06488
(203) 264-7999
(203) 264-7477
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
043995
CT
2085N0904X
Nuclear Radiology Physician
043995
CT
2085R0202X
Diagnostic Radiology Physician
Primary
043995
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001439951
—
CT
Enumeration date
10/17/2006
Last updated
06/17/2021
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