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Individual

VINCENT FIORE MANZO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
55 PALMER ROAD, BRONXVILLE, NY 10708
(914) 787-1000
Mailing address
722 LINDA AVENUE, THORNWOOD, NY 10594
(914) 776-4405

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
018968
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
93074884
GHI
NY
Enumeration date
09/18/2015
Last updated
09/18/2015
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