Provider Demographics
NPI:1619318748
Name:MANONI, CLETO J (RPH)
Entity type:Individual
Prefix:MR
First Name:CLETO
Middle Name:J
Last Name:MANONI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:937 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2833
Mailing Address - Country:US
Mailing Address - Phone:516-263-4149
Mailing Address - Fax:
Practice Address - Street 1:937 N 3RD ST
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2833
Practice Address - Country:US
Practice Address - Phone:516-263-4149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0422671835N0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835N0905XPharmacy Service ProvidersPharmacistNuclear