Individual
CRISTINA MANCUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
496 COUNTY ROAD 111 BLDG C, MANORVILLE, NY 11949-3385
(631) 399-0324
Mailing address
10 HILLCREST LN, RIDGE, NY 11961-3003
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
059252
NY
Other
Enumeration date
12/28/2020
Last updated
12/28/2020
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