Individual
JESSE MANGONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1117 US HIGHWAY 46, SUITE 202, CLIFTON, NJ 07013-2449
(973) 614-8484
Mailing address
PO BOX 7306, EAST RUTHERFORD, NJ 07073-7306
(973) 614-8484
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
25MB03219800
NJ
Other
Enumeration date
08/12/2006
Last updated
11/21/2007
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