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General NPI Number Information
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NPI Number | 1952976797
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Entity Type | Organization
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Legal Business Name | ROBERT F. MANCUSO MD PLLC
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Dates
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Enumeration Date | 05/24/2021
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Last Update Date | 05/24/2021
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Provider Practice Location Address
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Address Line | 8913 RIDGE BLVD
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City | BROOKLYN
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State | NY
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Zip | 11209-5715
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Country | US
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Telephone | 917-299-5512
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Fax |
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Provider Business Mailing Address
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Address Line | 8913 RIDGE BLVD
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City | BROOKLYN
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State | NY
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Zip | 11209-5715
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT MANCUSO
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Credential | MD
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Telephone | 917-299-5512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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