1457447195 NPI number — DR. ROBERT JOSEPH CUSUMANO M.D.

Table of content: DR. ROBERT JOSEPH CUSUMANO M.D. (NPI 1457447195)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457447195 NPI number — DR. ROBERT JOSEPH CUSUMANO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CUSUMANO
Provider First Name:
ROBERT
Provider Middle Name:
JOSEPH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1457447195
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/01/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
660 WHITE PLAINS RD FL 4
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TARRYTOWN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10591-5139
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-984-2546
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
690 KINDERKAMACK ROAD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
ORADELL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07649
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-722-9850
Provider Business Practice Location Address Fax Number:
201-722-9851
Provider Enumeration Date:
10/04/2006

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: 207Y00000X , with the licence number:  25MA05034500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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