Marisa M Mancuso, DO
Pediatrics in Boardman, OH. Individual provider (NPI-1).
NPI number1124647516
StatusActive
Last updated in NPPESJun 24, 2023
Details
- NPI
- 1124647516
- Entity type
- Individual (NPI-1)
- Name
- Marisa M Mancuso
- Credential
- DO
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 15, 2020
- Certification date
- Jun 24, 2023
- Last updated
- Jun 24, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | 34.016662 | OH | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
6505 Market StBoardman, OH 44512-1063
Phone 330-543-8178
Mailing address
1 Perkins SqAkron, OH 44308-1063
Phone 440-476-5722
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