Manchester, Mark G
Manchester, Mark G is an individual health care provider with primary practice located at 1 Montgomery St , Middletown NY 10940-5115. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Manchester, Mark G can be contacted via phone (845) 343-7337.Contact Information
Primary practice address
1 Montgomery St
Middletown NY 10940-5115
Phone: (845) 343-7337
Fax: (845) 343-1710
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | NA |
Profile Details
| NPI number | 1578653085 |
|---|---|
| LBN Legal business name | Manchester, Mark G |
| Credentials | CO2015 |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 13th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578653085 | NPPES |
| New York | MEDICAID | 00368350 |
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