Individual
DR. MARC WILLIAM MANSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
356 W 18TH ST, NEW YORK, NY 10011-4401
(347) 687-4704
Mailing address
237 DEVOE ST APT 3R, BROOKLYN, NY 11211-3806
(401) 524-1545
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
258596
NY
2084P0800X
Psychiatry Physician
Primary
258596
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
258596-1
NY STATE LICENSE
NY
Enumeration date
05/04/2009
Last updated
03/04/2025
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