Theresa Y. Mangual, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

028553 Issued in CT

Practice address

428 Hartford Tpke
Ste 201
Vernon, CT 06066-4841

Phone

(860) 871-7374

Fax

(860) 870-8686

NPI assigned

Mar 28, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mary Hitchcock Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1023092053
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318896000000",
    "number": "1598725988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 HARTFORD TPKE",
            "address_2": "STE 201",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664841",
            "telephone_number": "860-871-7374",
            "fax_number": "860-870-8686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 HARTFORD TPKE",
            "address_2": "STE 201",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664841",
            "telephone_number": "860-871-7374",
            "fax_number": "860-870-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGUAL",
        "first_name": "THERESA",
        "middle_name": "Y.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2011-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "028553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001285536",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rory Magliocco, DPT
• Lindsey Malchow, M.A., ED., B.C.B.A
• Neil L. Malkin, O.D.
• Elizabeth M Malone, OTR/L
• Kristen Maloney, CNP
• Ellen L Marmer, MD
• Elizabeth Ann Martin, MD
• Monique Renee Martin, MD
• Joseph Mascolo Sr., APRN
• Akhil Mathew

• Obstetrics & Gynecology Physician in Vernon, CT
• Providers in Vernon, CT by specialty
• Obstetrics & Gynecology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.