Provider Demographics
NPI:1174524417
Name:MANSER, KARL E (PT)
Entity type:Individual
Prefix:MR
First Name:KARL
Middle Name:E
Last Name:MANSER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 ENGLE ST
Mailing Address - Street 2:SUITE 17
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2440
Mailing Address - Country:US
Mailing Address - Phone:201-569-2320
Mailing Address - Fax:201-569-2321
Practice Address - Street 1:200 ENGLE ST
Practice Address - Street 2:SUITE 17
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2440
Practice Address - Country:US
Practice Address - Phone:201-569-2320
Practice Address - Fax:201-569-2321
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00251000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ647147OtherUNITED HEALTHCARE I.D. NO
NJ2094975OtherAETNA I.D. NUMBER
NJNJ4514OtherHEALTHNET I.D. NUMBER
NJP1673774OtherOXFORD I.D. NUMBER
NJQ82921OtherEMPIRE B/C B/S I.D. NO.
NJP1673774OtherOXFORD I.D. NUMBER