Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Advance Medical and Diet Services

Organization Family Medicine Physician · NPI 1861785149

Advance Medical and Diet Services is a Family Medicine Physician in Staten Island, New York. Licensed in New York. Registered with an NPI since 2011.

Licensed in
NY
In the registry since
2011

Practice location Address checks out

3930 Richmond Ave
Staten Island, NY 10312-5104
Phone: (718) 605-1040
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 166460 (NY)

Record details

NPI number1861785149
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Eugene Mancuso — President · (718) 605-1040
NPI enumeratedMay 19, 2011
Last updated in NPPESMay 19, 2011
Mailing address3930 Richmond Ave, Staten Island, NY 10312-5104

Other providers in Staten Island