1265996078 NPI number — ANDREW THOMAS CUMMINGS MS, ATC

Table of content: ANDREW THOMAS CUMMINGS MS, ATC (NPI 1265996078)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265996078 NPI number — ANDREW THOMAS CUMMINGS MS, ATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CUMMINGS
Provider First Name:
ANDREW
Provider Middle Name:
THOMAS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, ATC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265996078
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/26/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
41 LATHAM FARM RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SMITHFIELD
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02917-1026
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-743-2375
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 KEANEY ROAD
Provider Second Line Business Practice Location Address:
SUITE ONE
Provider Business Practice Location Address City Name:
KINGSTON
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02881
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-874-4804
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/25/2019

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: 2255A2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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