Advance Medical and Diet Services

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

166460 Issued in NY

Legal business name

ADVANCE MEDICAL AND DIET SERVICES

Practice address

3930 Richmond Ave
Staten Island, NY 10312-5104

Phone

(718) 605-1040

NPI assigned

May 19, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Eugene Mancuso

Title

President

Phone

(718) 605-1040

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1305763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305763200000",
    "number": "1861785149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125104",
            "telephone_number": "718-605-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE MEDICAL AND DIET SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-19",
        "last_updated": "2011-05-19",
        "status": "A",
        "authorized_official_last_name": "MANCUSO",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-605-1040",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "166460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Adrian, M.D.
• Josephine Adriano, RN
• Mary I Adukyei, DOCTOR OF PHARMACY
• Adult Geriatric Health NP PC
• Adult Medical Care, P.C.
• Advance Sleep Testing Inc
• Advanced Allergy & Asthma Family Care PLLC
• Advanced Care Audiology P.C.
• Advanced Hand & Occupational Therapy, PC
• Advanced Hand & Occupational Therapy, PC

• All providers in Staten Island, NY
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; 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.