MEDICARE: MARY MANCUSO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	192273	NY

General Provider Information

NPI Number	:	1487977815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY MANCUSO

Provider Business Mailing Address
First Line	:	PO BOX 679
Second Line	:
City	:	GLEN WILD
State	:	NY
Zip	:	12738-0679
Country	:	US
Telephone Number	:	845-434-4943
Fax Number	:

Provider Business Practice Location Address
First Line	:	54 W 40TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10018-2602
Country	:	US
Telephone Number	:	212-354-6000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2010
Last Update Date	:	03/13/2010

Similar Medicare Providers

1790832376 — DAYTOP VILLAGE INC.
Practice Location Address:

54 W 40TH ST
NEW YORK, NY
10018-2602

Practice Phone: 845-292-3296
Practice Fax:

1124178181 — MARY JANE DELGADO REGISTERED NURSE
Practice Location Address:

54 W 40TH ST , DAYTOP
NEW YORK, NY
10018-2602

Practice Phone: 845-292-6880
Practice Fax:

1710142666 — RANDALL M. HARRIS LCSW
Practice Location Address:

54 W 40TH ST , DAYTOP VILLAGE
NEW YORK, NY
10018-2602

Practice Phone: 845-292-2089
Practice Fax: 845-292-4652

1548548282 — MS. PATRICIA IRENE VANDERPLOEG L.P.N.
Practice Location Address:

54 W 40TH ST
NEW YORK, NY
10018-2602

Practice Phone: 845-292-6372
Practice Fax:

1598042947 — MRS. JAHKEIA RODGERS R.N.
Practice Location Address:

54 W 40TH ST
NEW YORK, NY
10018-2602

Practice Phone: 212-354-6000
Practice Fax:

1275223836 — YOUR THERAPEUTIC SPACE MENTAL HEALTH COUNSELING PLLC
Practice Location Address:

50 W 40TH ST
NEW YORK, NY
10018-2602

Practice Phone: 917-524-9534
Practice Fax:

Directions to “ MARY MANCUSO ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.