Doctor Name: | MARY CLARE MANINANG |
NPI Number: | 1417224841 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | MD450901 |
Business Practice Address: | 1033 Turnpike Ave Suite 200 Clearfield, PA - 168303061 |
Business Phone Number: | 8147687618 |
Business Fax Number: | 8147687508 |
Mailing Address: | 334 Winfield Ave, Floor 1 JERSEY CITY |
State: | NJ |
Postal Code: | 073051745 |
Phone Number: | 2019180861 |
Fax Number: | 2019180861 |
NPI Enumeration Date: | 11/30/2011 |
NPI Last Update Date: | 12/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | MD450901 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |