Individual
DR. THERESA Y. MANGUAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
428 HARTFORD TPKE, STE 201, VERNON, CT 06066-4841
(860) 871-7374
(860) 870-8686
Mailing address
428 HARTFORD TPKE, STE 201, VERNON, CT 06066-4841
(860) 871-7374
(860) 870-8686
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
028553
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001285536
—
CT
Enumeration date
03/28/2006
Last updated
10/18/2011
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