Individual
TINA MARIA MANCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
11150 HURON ST, 208, NORTHGLENN, CO 80234-4379
(303) 426-0633
(303) 426-0759
Mailing address
3306 DELAWARE AVE, BUFFALO, NY 14217-1723
(303) 953-5976
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
001416-01
NY
237600000X
Audiologist-Hearing Aid Fitter
525
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
61927872
—
CO
Enumeration date
06/20/2008
Last updated
05/25/2021
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