Organization
NY FOOT & ANKLE SPECIALISTS DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER JOHN MANCUSO DPM (OWNER)
(631) 231-1401
Entity
Organization
Contact information
Practice address
620 SUFFOLK AVE, BRENTWOOD, NY 11717-4306
(631) 231-1401
Mailing address
620 SUFFOLK AVE, BRENTWOOD, NY 11717-4306
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Enumeration date
05/29/2018
Last updated
05/29/2018
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