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Individual

DEAN MANCUSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AUD

Contact information

Practice address
180 FORT WASHINGTON AVE, 7TH FLOOR, NEW YORK, NY 10032-3722
(212) 305-8555
Mailing address
180 FORT WASHINGTON AVE, 7TH FLOOR, NEW YORK, NY 10032-3722
(212) 305-8555

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
001678
NY
237600000X
Audiologist-Hearing Aid Fitter
14000009853
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001678
NYS AUDIOLOGY LICENSE
NY
01
14000009853
NYS HEARING AID DISPENSER
NY
Enumeration date
02/05/2007
Last updated
05/12/2014
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