Mango, Charles

Mango, Charles is an sole proprietor health care provider with primary practice located at 1101 Erie Blvd E Ste 210, Syracuse NY 13210-1144. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Mango, Charles can be contacted via phone (315) 218-7591.

Contact Information

Primary practice address
1101 Erie Blvd E Ste 210 Syracuse NY 13210-1144
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 106955 New York

Profile Details

NPI number 1285637611
LBN Legal business name Mango, Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 31st, 2005
Last updated Jan 5th, 2017 - about 7 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 1285637611 NPPES
New York MEDICAID 00550014

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