Individual
DR. KENNETH FRANCIS MANCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1415 TULANE AVE, NEW ORLEANS, LA 70112-2600
(504) 988-3904
Mailing address
81 SCHILL AVE, KENNER, LA 70065-3352
(504) 305-5261
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD.201319
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01159802
—
MS
05
—
1216607
—
LA
Enumeration date
04/22/2008
Last updated
02/17/2011
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