Doctor Name: | CARMEN MANZO-GORAL |
NPI Number: | 1215308705 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | 26NJ00596500 |
Business Practice Address: | 1040 Highway 36 Atlantic Highlands, NJ - 077162506 |
Business Phone Number: | 7322913400 |
Business Fax Number: | |
Mailing Address: | 9 S Arlene Dr, WEST LONG BRANCH |
State: | NJ |
Postal Code: | 077641160 |
Phone Number: | 7322416005 |
Fax Number: | |
NPI Enumeration Date: | 10/09/2015 |
NPI Last Update Date: | 10/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | 26NJ00596500 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |