Individual
JULIA MANCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FOGG RD, SOUTH WEYMOUTH, MA 02190-2432
(781) 624-8000
Mailing address
55 FOGG RD, SOUTH WEYMOUTH, MA 02190-2432
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2266454
MA
Other
Enumeration date
08/13/2015
Last updated
08/13/2015
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