Individual
DR. JOHN EDWARD MANCUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
133 E 54TH ST, NEW YORK, NY 10022-4538
(212) 759-9090
(212) 371-2830
Mailing address
133 E 54TH ST, NEW YORK, NY 10022-4538
(212) 759-9090
(212) 371-2830
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
N003102
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NS782
OXFORD
NY
01
—
P34331
BC/BS
NY
01
—
P34332
BC/BS
NY
01
—
P34333
BC/BS
NY
Enumeration date
09/02/2006
Last updated
11/02/2007
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