Individual
ROBERT F MANCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1920 E CAMBRIDGE AVE STE 201, PHOENIX, AZ 85006-1462
(602) 933-3277
(602) 933-4326
Mailing address
2108 E THOMAS RD, PHOENIX, AZ 85016-7761
(602) 933-3124
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
28884
AZ
207YP0228X
Pediatric Otolaryngology Physician
Primary
28884
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28884
MEDICAL BOARD STATE LICEN
AZ
05
—
560129
—
AZ
Enumeration date
04/20/2006
Last updated
10/22/2024
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