Provider Information for 1487828554
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Mr. VICTOR JOHN MANOCCHIO II LCSW
Sex: Male
NPI: 1487828554
Last Updated: 2015-04-23
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1487828554 | ||||||||
| Enumeration Date | 2008-04-18 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 6 SUNNYSIDE RD TUNKHANNOCK, PA 18657-6950 United States Phone: 570-836-7777 | Fax:570-836-7479 | ||||||||
| Primary Practice Address | 6 SUNNYSIDE RD TUNKHANNOCK, PA 18657-6950 United States Phone: 570-836-7777 | Fax:570-836-7479 | ||||||||
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