Individual
DR. CHRISTOPHER J MANCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 S 7TH AVE, SUITE 3220, WEST READING, PA 19611-1410
(610) 376-8671
(610) 376-6387
Mailing address
301 S 7TH AVE, SUITE 3220, WEST READING, PA 19611-1410
(610) 376-8671
(610) 376-6387
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
MD059819L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018225700001
—
PA
01
—
01925801
CAPITAL BLUE CROSS
PA
01
—
MA561226
BLUE SHEILD
PA
Enumeration date
08/11/2005
Last updated
09/11/2014
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