Mancuso, Peter John

Mancuso, Peter John is an sole proprietor health care provider with primary practice located at 620 Suffolk Ave , Brentwood NY 11717-4306. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Mancuso, Peter John can be contacted via phone (631) 231-1401.

Contact Information

Primary practice address
620 Suffolk Ave Brentwood NY 11717-4306
Phone: (631) 231-1401
Fax: (631) 273-0125
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X N0056351 New York

Profile Details

NPI number 1558339200
LBN Legal business name Mancuso, Peter John
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 9th, 2006
Last updated Apr 27th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558339200 NPPES
New York MEDICAID 02049347

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