Individual
MR. EDWARD D MANZELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1353 STATE ROUTE 903, JIM THORPE, PA 18229-2734
(570) 325-8393
(570) 325-8029
Mailing address
1605 N CEDAR CREST BLVD STE 110B, ALLENTOWN, PA 18104-2351
(610) 973-1410
(610) 973-1449
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD047252L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001442722
—
PA
01
—
010654900
BLACK LUNG
—
01
—
0274540000
PERSONAL CHOICE BLUE SHIE
—
01
—
03277800
CAPITAL BLUE CROSS GROUP
—
01
—
03277901
CAPITAL BLUE CROSS
—
01
—
110101
AMERIHEALTH ADMIN
—
01
—
1753980
FEDERAL BLUE SHIELD
—
01
—
20031254
AMERIHEALTH MERCY
—
01
—
2420346000
PERSONAL CHOICE BLUE SHIE
—
01
—
5389099
AETNA
—
01
—
6002088
GHI
—
01
—
810651818
COVENTRY HEALTH
—
01
—
P00387554
PALMETTO GBA GROUP
PA
Enumeration date
12/08/2005
Last updated
03/29/2023
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