1760698906 NPI number — DR. CYNTHIA LYNNE MORRIS-KUKOSKI PHARM.D.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760698906 NPI number — DR. CYNTHIA LYNNE MORRIS-KUKOSKI PHARM.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORRIS-KUKOSKI
Provider First Name:
CYNTHIA
Provider Middle Name:
LYNNE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KUKOSKI
Provider Other First Name:
CYNTHIA
Provider Other Middle Name:
LYNNE MORRIS
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARM.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1760698906
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
231 DOE WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FREDERICKSBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22406-4644
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-752-8204
Provider Business Mailing Address Fax Number:
540-752-8204

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2501 INVESTIGATION PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
QUANTICO
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22135-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-632-7838
Provider Business Practice Location Address Fax Number:
703-632-7411
Provider Enumeration Date:
05/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  20504 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 183500000X , with the licence number: 7673 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)





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