Individual
DR. STEPHEN J MANOCCHIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
268 DR MARTIN LUTHER KING JR BLVD, NEWARK, NJ 07102-2011
(973) 877-2586
Mailing address
PO BOX 36, ROSELAND, NJ 07068-0036
(973) 877-2586
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA38532
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048640
—
NJ
Enumeration date
06/21/2006
Last updated
03/06/2008
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