Individual
SAMMANTHA MARIE MANCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
383 THORNYCROFT AVE, STATEN ISLAND, NY 10312-5138
(848) 218-1278
Mailing address
383 THORNYCROFT AVE, STATEN ISLAND, NY 10312-5138
(848) 218-1278
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
875516
NY
Other
Enumeration date
10/29/2024
Last updated
10/29/2024
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