National Provider Identifier
Lauren Maria Mancuso, PA
Lauren Maria Mancuso, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Depew, NY and a listed phone number of (716) 845-1600.
Profile Overview
- NPI
- 1760899769
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- July 22, 2014
- Last Updated
- January 24, 2023
Practice Location
- 6420 Transit RD Ste A
- Depew, NY 14043-1033
Phone: (716) 845-1600
Mailing Address
- 3041 Orchard Park RD Ste C
- Att: Credentialing
- Orchard Par, NY 14127-1238
Specialties
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1760899769
- Entity Type
- Individual
- Last Name
- Mancuso
- First Name
- Lauren
- Middle Name
- Maria
- Name Prefix
- Mrs.
- Credential
- PA
- Provider Other Last Name
- Mickiewicz
- Provider Other First Name
- Lauren
- Provider Other Middle Name
- Maria
- Provider Other Credential Text
- PA
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 3041 Orchard Park RD Ste C
- Mailing Address Line 2
- Att: Credentialing
- Mailing City
- Orchard Par
- Mailing State
- NY
- Mailing ZIP Code
- 14127-1238
- Mailing Country
- US
- Mailing Phone
- (716) 674-3104
- Mailing Fax
- (716) 674-0666
- Practice Street Address
- 6420 Transit RD Ste A
- Practice City
- Depew
- Practice State
- NY
- Practice ZIP Code
- 14043-1033
- Practice Country
- US
- Practice Phone
- (716) 845-1600
- Practice Fax
- (716) 242-0201
- Enumeration Date
- July 22, 2014
- Last Updated
- January 24, 2023
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- January 24, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X)
- Other Identifiers
- 04020848 (NY)