Organization
PENNMED CARE PA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MANZELLA DO (ADMINISTRATOR)
(215) 709-3800
Entity
Organization
Contact information
Practice address
841 E HUNTING PARK AVE STE 110, PHILADELPHIA, PA 19124-4813
(215) 709-3800
(215) 476-1427
Mailing address
PO BOX 9369, PHILADELPHIA, PA 19139-9369
(215) 709-3800
(215) 476-1427
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RI0011X
Interventional Cardiology Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
01/28/2025
Last updated
02/05/2025
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