Individual
PETER MANCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 STEPHEN HANDS PATH, WAINSCOTT, NY 11975
(631) 324-0207
(631) 824-9050
Mailing address
142 S HICKORY ST, PORT JEFFERSON STATION, NY 11776-3152
(631) 324-0207
(631) 824-9050
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
06/25/2014
Last updated
06/25/2014
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