Individual ProviderMarie Louise ManninoInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address91 Mountain Ave, Hawthorne, NJ 07506-3331(973) 423-3534PECOS EnrollmentBased on the most recent information from CMS, provider Marie Louise Mannino does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1790022556Provider TypeIndividualFull NameMannino, Marie LouiseTitleDr.CredentialM.D.GenderFemaleSole ProprietorYesEnumeration Date1/13/2013Last Updated1/13/2013Contact InformationPractice LocationPractice Address91 Mountain Ave, Hawthorne, NJ 07506-3331Phone(973) 423-3534FaxUnlisted FaxMailing LocationMailing Address91 Mountain Ave, Hawthorne, NJ 07506-3331Phone(973) 423-3534FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense25MA04197906New Jersey