Provider Demographics
NPI:1124033907
Name:MANZANO, RAMIRO J (DPM)
Entity type:Individual
Prefix:
First Name:RAMIRO
Middle Name:J
Last Name:MANZANO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:140 COMMONWEALTH AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3625
Mailing Address - Country:US
Mailing Address - Phone:978-777-7707
Mailing Address - Fax:978-777-3402
Practice Address - Street 1:140 COMMONWEALTH AVE STE 107
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3625
Practice Address - Country:US
Practice Address - Phone:978-777-7707
Practice Address - Fax:978-777-3402
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2025-07-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA2029213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0307343Medicaid
762352OtherTUFTS
27-40037OtherUNITED
Y70991Medicare PIN
MA0307343Medicaid