Gloria Kay Mancuso, OG NP

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

F390002 Issued in NY

Practice address

365 East Main St
South Brookhaven Health Center West
Patchogue, NY 11772

Phone

(631) 854-1307

Fax

(631) 854-1310

NPI assigned

Aug 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of Suffolk

  dba Bureau of Public Health Nursing-LTHC

  • Home Health Agency
  • Great River, NY
  • NPI 1497859615
  NPD (past)
• County of Suffolk

  dba Bureau of Public Health Nursing - CHHA

  • Home Health Agency
  • Great River, NY
  • NPI 1871506055
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962411181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 EAST MAIN ST",
            "address_2": "SOUTH BROOKHAVEN HEALTH CENTER WEST",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "11772",
            "telephone_number": "631-854-1307",
            "fax_number": "631-854-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 EAST MAIN ST",
            "address_2": "SOUTH BROOKHAVEN HEALTH CENTER WEST",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "11772",
            "telephone_number": "631-854-1307",
            "fax_number": "631-854-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCUSO",
        "first_name": "GLORIA",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "OG NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NY",
            "license": "F390002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Main Street Medical Imaging, PC
• Main Street Primary Medicine
• Jayeshkumar Makavana, MD
• Nita Krishna Malik, N.P.
• Gary D Mancuso, RPH
• Mary Ashley Manetta, PHYSICIAN ASSISTANT
• Morgan Grace Manganello, PA-C
• Pamela Mary Manganello
• Susan Mann, RN
• Sarina Isaella Mannino

• Obstetrics & Gynecology Nurse Practitioner in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Obstetrics & Gynecology Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.