Augustus G Mantia MD

NPI 1588662829 - Internal Medicine - 207R00000X

NPI Details
NPI 1588662829
Gender Male
Enumeration Date 07/11/2005
Last Updated 04/22/2015
Entity Type Individual
Active Over 11 years ago
Practice Location
59 SOUTHERN BLVD
NESCONSET NY, 11767-1090, US
Phone (631) 659-1700
Fax (631) 659-1750
Business Location
59 SOUTHERN BLVD
NESCONSET NY, 11767-1090, US
Phone (631) 659-1700
Fax (631) 659-1750
Toxanomy
Taxonomy Code 207R00000X
License State New York
License Number 124142
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According to our database, Augustus G Mantia MD NPI is 1588662829, taxonomy code is 207R00000X and license number is 124142, license state is located at New York. Augustus G Mantia MD physically located at 59 Southern Blvd, Nesconset NY, 11767-1090. NPI Number Augustus G Mantia MD has the Individual type.

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1588662829 NPI number is provided on an as is basis without warranty of any kind. 1588662829 is maintained by the National Plan & Provider Enumeration System. The contents of Augustus G Mantia MD are for informational purposes only.