JENNIFER BRESCOLL MANCUSO (NPI# 1871912550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871912550 |
| Entity Type | Individual |
| Full Name | JENNIFER BRESCOLL MANCUSO |
| Other Name | JENNIFER SUSAN BRESCOLL |
| Credential | MD |
| Practice Address |
1500 East Medical Center Dr 1st Floor Taubman Center Recp 'b' Ann Arbor MI 48109-5314 |
| Mailing Address |
3621 S State St Ann Arbor MI 48108-1633 |
| Practice Telephone | 7349364054 |
| Mailing Telephone | 7346475299 |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2018-12-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 4301105772 | MI | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2799 W Grand Blvd, 2799 W. Grand Boulevard, Detroit, MI 482022608 | 3139162600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003204611 | Jennifer Mancuso | Genetic Counselor, MS | 200 Hawkins Dr, 31663 Pfp, Iowa City, IA 52242-1009 | 2015-01-05 |
| 1548658164 | Jennifer Cathleen Mancuso | Registered Nurse | 424 Savannah Rd, Lewes, DE 19958-1462 | 2015-01-05 |
| 1467652362 | Jennifer A Mancuso | Occupational Therapy Assistant | 5943 Telegraph Rd, Saint Louis, MO 63129-4715 | 2007-07-19 |
| 1003952433 | Jennifer Ann Mancuso | Occupational Therapist | 168 Cherry Ln, Carle Place, NY 11514-1741 | 2007-01-30 |
| Street Address |
1500 EAST MEDICAL CENTER DR 1ST FLOOR TAUBMAN CENTER RECP 'B' |
| City | ANN ARBOR |
| State | MI |
| Zip Code | 48109-5314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063417731 | Daniel William Berland | Internal Medicine | 1500 East Medical Center Dr, 3rd Floor Taubman Ctr Recp B, Ann Arbor, MI 48109-5352 | 2005-06-17 |
| 1770105405 | Emily Ager | Student in an Organized Health Care Education/Training Program | 1500 East Medical Center Dr, B1-380 Taubman Center, Ann Arbor, MI 48109-5305 | 2020-05-15 |
| 1922668987 | Matthew James Wolf | Pediatrics | 1500 East Medical Center Dr, Ann Arbor, MI 48109-5718 | 2019-06-20 |
| 1235799644 | Helen Elizabeth Mulcahy | Pediatrics | 1500 East Medical Center Dr, Ann Arbor, MI 48109-5718 | 2019-06-18 |
| 1679133490 | Alexander Charles Waselewski | Pediatrics | 1500 East Medical Center Dr, Ann Arbor, MI 48109-5718 | 2019-06-14 |
| 1043870868 | Danielle Rose Vanbeckum | Pediatrics | 1500 East Medical Center Dr, Ann Arbor, MI 48109-5718 | 2019-06-14 |
| 1881254621 | Megan Kathryn Zakerski | Pediatrics | 1500 East Medical Center Dr, Ann Arbor, MI 48109-5718 | 2019-06-14 |
| 1104484625 | Alicia Isabelle Rolin | Pediatrics | 1500 East Medical Center Dr, Ann Arbor, MI 48109-5718 | 2019-05-30 |
| 1417515933 | Kristen Elizabeth Unsicker | Pediatrics | 1500 East Medical Center Dr, Ann Arbor, MI 48109-5718 | 2019-05-30 |
| 1760040273 | Katie Christine Ramos | Pediatrics | 1500 East Medical Center Dr, Ann Arbor, MI 48109-5718 | 2019-05-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558987024 | Albert Byun | Student in an Organized Health Care Education/Training Program | 1500 E.medical Center Dr., 1h247, Ann Arbor, MI 48109 | 2020-06-22 |
| 1851914931 | Nadine Ibrahim | Student in an Organized Health Care Education/Training Program | 1500 E. Medical Center Drive, Spc 5312, Taubman Center, 1st Floor, Room 1903, Ann Arbor, MI 48109 | 2020-05-22 |
| 1568083350 | Tucker Zimmer | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Dr, Uh South F-6245, Ann Arbor, MI 48109 | 2020-05-03 |
| 1144841099 | Jessica Moore Meves | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Drive, Uh South F-6245, Ann Arbor, MI 48109 | 2020-05-01 |
| 1710522297 | Xiaoyuan Hu | Specialist/Technologist | Obl 2150, 1402 Washington Hts, Ann Arbor, MI 48109 | 2019-11-08 |
| 1376192401 | Regina Kay Freeman | Clinical Nurse Specialist | 4726 Cardiovascular Center, 1500 E Medical Center Dr, Ann Arbor, MI 48109 | 2019-09-11 |
| 1477114155 | William Philip Saunders IIi | Student in an Organized Health Care Education/Training Program | 300 N Ingalls Building, Rm Ni4co6, Ann Arbor, MI 48109 | 2019-06-24 |
| 1093290447 | Teresa H Lyden | Speech-Language Pathologist | 1500 E. Medical Center Dr., Spc 5312, 1904 Tc, Otolaryngology-head and Neck Surgery, Ann Arbor, MI 48109 | 2018-10-02 |
| 1649755091 | Anna Grace Hardenbergh | Speech-Language Pathologist | 1500 E. Medical Center Drive Tc 1904, Otolaryngology Head and Neck Surgery, Ann Arbor, MI 48109 | 2018-10-02 |
| 1548754609 | Amy Wu | Pediatrics | 1500 East Medical Center Drive., Medical Professional Bldg. D-3238, Ann Arbor, MI 48109 | 2018-06-21 |
| Find all providers in zip 48109 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790132439 | Saara Kanervikkoaho-crane | Dermatology | 1517 Granger Ave, Ann Arbor, MI 48104-4426 | 2016-05-23 |
| 1174915532 | Sonam Rama | Dermatology | 305 E Eisenhower Pkwy Ste 320, Ann Arbor, MI 48108 | 2015-02-23 |
| 1235576174 | Matthew Paul Vasievich | Dermatology | 4200 Whitehall Dr Ste 250, Ann Arbor, MI 48105-9694 | 2013-06-02 |
| 1013114602 | Frank Wang | Dermatology | 1500 E. Medical Ctr Dr, 1st Floor Taubman Center Recp B, Ann Arbor, MI 48109-5314 | 2007-06-28 |
| 1306967542 | Arthur P Bertolino | Dermatology | 2800 Plymouth Rd, Ann Arbor, MI 48105-2430 | 2007-04-03 |
| 1770673436 | Anastasia Petro Dimick | Dermatology | 2433 Oak Valley Dr., Ste. 400, Ann Arbor, MI 48103 | 2006-10-13 |
| 1962592626 | Kathy Laing, M.d., P.C. | Dermatology | 2433 Oak Valley Drive, Suite 400, Ann Arbor, MI 48103 | 2006-10-13 |
| 1255428025 | Timothy M Johnson | Dermatology | 1979 Huron Pkwy, Ann Arbor, MI 48104-4141 | 2006-10-05 |
| 1487600474 | Muna K. Farjo,m.d., P.C. | Dermatology | 3001 Plymouth Rd, Suite # 101, Ann Arbor, MI 48105-3205 | 2006-05-25 |
| 1407841349 | Joan Marie Rindler | Dermatology | 2301 S Huron Pkwy, Suite 2b, Ann Arbor, MI 48104-5133 | 2005-09-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.