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

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1750086518

Logan J Mancuso, MD is a Student in an Organized Health Care Education/Training Program in Stony Brook, New York. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone: (631) 689-8333
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1750086518
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 3, 2023
Last updated in NPPESApril 3, 2023
Certification dateApril 2, 2023

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