Mancuso, Thomas J

Mancuso, Thomas J is an individual health care provider with primary practice located at 300 Longwood Ave , Boston MA 02115-5724. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Mancuso, Thomas J can be contacted via phone (617) 355-8984.

Contact Information

Primary practice address
300 Longwood Ave Boston MA 02115-5724
Phone: (617) 355-8984
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207LC0200X 53088 Massachusetts
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 53088 Massachusetts

Profile Details

NPI number 1316916737
LBN Legal business name Mancuso, Thomas J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2006
Last updated Aug 20th, 2007 - about 19 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 1316916737 NPPES
Massachusetts MEDICAID 3174166

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