Provider Demographics
NPI:1750360244
Name:MANZO, MARTIN E (DC)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:E
Last Name:MANZO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:404 LIPPINCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4112
Mailing Address - Country:US
Mailing Address - Phone:856-782-3300
Mailing Address - Fax:856-504-8029
Practice Address - Street 1:2399 ROUTE 34
Practice Address - Street 2:BUILDING A SUITE 5
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1500
Practice Address - Country:US
Practice Address - Phone:732-528-5533
Practice Address - Fax:732-528-0360
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ3306111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0184062OtherAETNA US HEALTHCARE
NJP549361OtherOXFORD
NJ1004122OtherCIGNA
NJ208420693OtherUNITED HEALTHCARE
NJ208420693OtherHORIZON BCBS
NJ208420693OtherTAX IDENTIFICATION NUMBER
NJOK4233OtherHEALTH NET
NJOK6534OtherGUARDIAN
NJ1926608Medicaid
NJ222951809OtherHORIZON BCBSNJ
NJ21168644851OtherBEECH STREET
NJ0105250000OtherAMERIHEALTH
NJT82467Medicare UPIN
NJ1926608Medicaid