Provider Demographics
NPI:1447203534
Name:MANGANO, TRISHA LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:TRISHA
Middle Name:LYNN
Last Name:MANGANO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 WILMINGTON W CHESTER PIKE STE 214
Mailing Address - Street 2:
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-9007
Mailing Address - Country:US
Mailing Address - Phone:844-365-7246
Mailing Address - Fax:610-361-7956
Practice Address - Street 1:1197 AIRPORT RD FL 2
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-6418
Practice Address - Country:US
Practice Address - Phone:844-365-7246
Practice Address - Fax:844-516-0080
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF10000539111N00000X
VA0104001485111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA259240OtherANTHEM PROVIDER NUMBER
VA350001216Medicare ID - Type UnspecifiedPROVIDER NUMBER
VA259240OtherANTHEM PROVIDER NUMBER