Anthony J. Mancuso, OD, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG000818 Issued in PA

Legal business name

ANTHONY J. MANCUSO, OD, LLC

Practice address

155 E Market St
Suite 2
Blairsville, PA 15717-1357

Phone

(724) 459-6610

Fax

(724) 459-6630

NPI assigned

Apr 26, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Martina Ann Mancuso

Title

Office Manager

Phone

(724) 459-6610

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1104882208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 E MARKET ST",
            "address_2": "SUITE 2",
            "city": "BLAIRSVILLE",
            "state": "PA",
            "postal_code": "157171357",
            "telephone_number": "724-459-6610",
            "fax_number": "724-459-6630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 E MARKET ST",
            "address_2": "SUITE 2",
            "city": "BLAIRSVILLE",
            "state": "PA",
            "postal_code": "157171357",
            "telephone_number": "724-459-6610",
            "fax_number": "724-459-6630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY J. MANCUSO, OD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "MANCUSO",
        "authorized_official_first_name": "MARTINA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "724-459-6610",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF2054",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Blairsville, PA
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.