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FAITH CONSTANCE MANCUSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP RN

Contact information

Practice address
500 COMMACK RD UNIT 204, COMMACK, NY 11725-5022
(631) 855-1200
Mailing address
42 ELDER DR, COMMACK, NY 11725-2332
(631) 258-1606

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F341728-1
NY

Other

Enumeration date
09/24/2017
Last updated
03/11/2020
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