Individual
DAVID MANCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
75 KINGS HWY E FL 4, FAIRFIELD, CT 06825-4823
(203) 337-2677
Mailing address
1 WALTER AVE APT B41, NORWALK, CT 06851-4137
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5830
LICENSE#
CT
Enumeration date
06/21/2007
Last updated
07/08/2007
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