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NPI Code Detail

MEDICARE: DR. EUGENE JOHN MANCUSO MD

MEDICARE: DR. EUGENE JOHN MANCUSO MD
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
1207Q00000XFamily Medicine Physician166460NY

General Provider Information

NPI Number : 1831234442
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EUGENE JOHN MANCUSO MD
Provider Business Mailing Address
First Line : 2915 AVENUE S
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-2544
Country : US
Telephone Number : 718-998-9669
Fax Number : 718-339-5614
Provider Business Practice Location Address
First Line : 2915 AVENUE S
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-2544
Country : US
Telephone Number : 718-998-9669
Fax Number : 718-339-5614
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2007
Last Update Date : 10/22/2018

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Directions to “ DR. EUGENE JOHN MANCUSO MD” Practice Location

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