# NY FOOT & ANKLE SPECIALIST DPM PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** NY Foot & Ankle Specialists
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851472419
- **Authorized official:** DR. PETER J MANCUSO DPM (OWNER)
- **Authorized official phone:** (631) 231-1401

## Contact information

- **Practice address:** 620 SUFFOLK AVE, BRENTWOOD, NY 11717
- **Practice address phone:** (631) 231-1401
- **Practice address fax:** (631) 273-0125
- **Mailing address:** 620 SUFFOLK AVE, BRENTWOOD, NY 11717-4306
- **Mailing address phone:** (631) 231-1401
- **Mailing address fax:** (631) 273-0125

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | N005635 | NY | Yes |

## Other

- **Enumeration date:** 10/18/2006
- **Last updated:** 06/07/2018