Organization
OPTIMUM PODIATRY GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER MANCUSO DPM (OWNER)
(631) 968-5600
Entity
Organization
Contact information
Practice address
620 SUFFOLK AVE, BRENTWOOD, NY 11717-4306
(631) 968-5600
Mailing address
620 SUFFOLK AVE, BRENTWOOD, NY 11717-4306
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
01/02/2024
Last updated
01/02/2024
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