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NPI Code Detail

MEDICARE: ROBERT F MANCUSO M.D.

MEDICARE: ROBERT F MANCUSO M.D.
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
1207Y00000XOtolaryngology Physician28884AZ
2207YP0228XPediatric Otolaryngology Physician28884AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
128884OTHERAZMEDICAL BOARD STATE LICEN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528023439
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT F MANCUSO M.D.
Provider Business Mailing Address
First Line : 2108 E THOMAS RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-7761
Country : US
Telephone Number : 602-933-3124
Fax Number :
Provider Business Practice Location Address
First Line : 1920 E CAMBRIDGE AVE STE 201
Second Line :
City : PHOENIX
State : AZ
Zip : 85006-1462
Country : US
Telephone Number : 602-933-3277
Fax Number : 602-933-4326
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2006
Last Update Date : 10/22/2024

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Directions to “ ROBERT F MANCUSO M.D.” Practice Location

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