Individual
KENNETH F MANGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-4000
(215) 707-5066
Mailing address
PO BOX 827783, PHILADELPHIA, PA 19182-7783
(215) 707-4000
(215) 707-5066
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
MD025673E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008685570001
—
PA
Enumeration date
10/12/2005
Last updated
02/08/2010
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