Active NPI
David Mancuso
- Physical Therapist
- Fairfield, CT
National Provider Identifier
1962608620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 75 Kings Hwy E FL 4
Fairfield, CT 06825-4823 - Phone
- (203) 337-2677
- NPI assigned
- Jun 21, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NU | Primary |
Addresses
Primary practice location
75 Kings Hwy E FL 4
Fairfield, CT 06825-4823
Mailing address
1 Walter Ave Apt B41
Norwalk, CT 06851-4137
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5830 | Other | CT | LICENSE# |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5830 | CT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962608620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 WALTER AVE APT B41",
"city": "NORWALK",
"state": "CT",
"postal_code": "068514137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 KINGS HWY E FL 4",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068254823",
"telephone_number": "203-337-2677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANCUSO",
"first_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE#",
"identifier": "5830",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CT
Sources for this page
- 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.