Provider Demographics
NPI:1902797145
Name:MANNA, MATTHEW JOSEPH (MPAS, PA-C)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:JOSEPH
Last Name:MANNA
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Gender:M
Credentials:MPAS, PA-C
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Mailing Address - Street 1:11 CEDAR ST N
Mailing Address - Street 2:
Mailing Address - City:KINGS PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11754-1504
Mailing Address - Country:US
Mailing Address - Phone:631-672-0160
Mailing Address - Fax:
Practice Address - Street 1:60 FLEETS POINT DR
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-8314
Practice Address - Country:US
Practice Address - Phone:631-689-6698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant