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Individual

MARK J MANCUSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1555 LONG POND RD, ROCHESTER, NY 14626-4122
(585) 255-8966
Mailing address
PO BOX 2005, EAST SYRACUSE, NY 13057-4505
(315) 449-0513
(315) 445-2936

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
190093
NY

Other

Enumeration date
10/18/2005
Last updated
07/08/2007
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