Manganiello, Richard John

Manganiello, Richard John is an sole proprietor health care provider with primary practice located at 479 Buckland Rd , South Windsor CT 06074-3739. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Manganiello, Richard John can be contacted via phone (860) 644-5011.

Contact Information

Primary practice address
479 Buckland Rd South Windsor CT 06074-3739
Phone: (860) 644-5011
Fax: (860) 644-4833
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 035387 Connecticut

Profile Details

NPI number 1003881764
LBN Legal business name Manganiello, Richard John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 17th, 2006
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003881764 NPPES
Connecticut Other 010035387CT01 BLUE CROSS
Connecticut Other 035387 BLUE CROSS
Connecticut Other 0005955242 BLUE CROSS
Connecticut Other P405022 BLUE CROSS
Connecticut MEDICAID 4216629 BLUE CROSS
Connecticut Other OV8008 BLUE CROSS

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