Provider Demographics
NPI:1093699977
Name:MANZI, MARCO A (RDN)
Entity type:Individual
Prefix:MR
First Name:MARCO
Middle Name:A
Last Name:MANZI
Suffix:
Gender:M
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 HIGHVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-1635
Mailing Address - Country:US
Mailing Address - Phone:973-856-9445
Mailing Address - Fax:
Practice Address - Street 1:82 HIGHVIEW AVE
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-1635
Practice Address - Country:US
Practice Address - Phone:973-856-9445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ86403788133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered