# FAMILY MEDICAL CARE OF MARINE PARK, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902004484
- **Authorized official:** DR. EUGENE JOHN MANCUSO MD (PRESIDENT)
- **Authorized official phone:** (718) 998-9669

## Contact information

- **Practice address:** 2915 AVENUE S, BROOKLYN, NY 11229-2544
- **Practice address phone:** (718) 998-9669
- **Practice address fax:** (718) 339-5614
- **Mailing address:** 2915 AVENUE S, BROOKLYN, NY 11229
- **Mailing address phone:** (718) 998-9669
- **Mailing address fax:** (718) 339-5614

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/06/2007
- **Last updated:** 05/28/2014