Individual
LON PHILIP MANFREDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
388 WEST CENTER ST, MANCHESTER, CT 06040
(860) 649-1120
(860) 645-8541
Mailing address
388 WEST CENTER ST, MANCHESTER, CT 06040
(860) 649-1120
(860) 645-8541
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
031483
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001314830
—
CT
Enumeration date
09/08/2006
Last updated
09/15/2009
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