Individual
MS. ANDREA MARIE MANCUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS.SPED
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1898917
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
174400000X
SPECIALIST
NY
Enumeration date
06/20/2012
Last updated
06/20/2012
Update your record
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