THOMAS J MANGO MD PC
Medical Practice at Oak St, Canaan Lake, NY

License number
New York 210442
Category
Medical Practice
Type
Specialist
Owner
Name: MRS. GINA BANCROFT
Title: MANAGER
Phone: (631) 758-3911
Address
Address
31 Oak St SUITE 3, Canaan Lake, NY 11772
National Provider ID: 1609838259
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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THOMAS J. MANGO, M.D., PC

31 Oak St STE 3, Patchogue, NY 11772

Industry:
Medical Doctor's Office
Doing business as:
Thomas J Mango MD PC
Registration:
Jul 1, 2002
State ID:
2784509
Business type:
DOMESTIC PROFESSIONAL CORPORATION
Chief Executive Officer, Principals:
Gina Bancroft (Manager),Thomas Mango Chief Executive Officer, Principal, inactive, Spinal Orthopedic Surgerl Etal 31 Oak St STE 3, Patchogue, NY 11772 (Physical)
Agent:
Spinal Orthopedic Surgerl Of Suffolk,31 Oak St STE 3, Patchogue, NY 11772 (Physical)

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