Individual
DR. BRUCE MANZIELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
NORTHERN ARIZONA VA HEALTH CARE SYSTEM, 5000 N. HIGHWAY 89, PRESCOTT, AZ 86313
(928) 445-4860
(928) 776-6084
Mailing address
PO BOX 150, PRESCOTT, AZ 86302-0150
(928) 445-4860
(928) 776-6084
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
127042
NY
Other
Enumeration date
07/11/2006
Last updated
07/08/2007
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