Individual
MARISA M MANCUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
6505 MARKET ST, BOARDMAN, OH 44512-1063
(330) 543-8178
Mailing address
1 PERKINS SQ, AKRON, OH 44308-1063
(440) 476-5722
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
34.016662
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2020
Last updated
06/24/2023
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