1871841627 NPI number — ROBERT B. CUCINOTTA MD INC.

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 1871841627 NPI number — ROBERT B. CUCINOTTA MD INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBERT B. CUCINOTTA MD INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1871841627
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/06/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1010 CEREAL AVE.
Provider Second Line Business Mailing Address:
SUITE 209
Provider Business Mailing Address City Name:
HAMILTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45013-2776
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-867-2834
Provider Business Mailing Address Fax Number:
513-867-2873

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1010 CEREAL AVE.
Provider Second Line Business Practice Location Address:
SUITE 209
Provider Business Practice Location Address City Name:
HAMILTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45013-2776
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-867-2834
Provider Business Practice Location Address Fax Number:
513-867-2873
Provider Enumeration Date:
08/28/2012

Additional Information

Authorized Official

Authorized Official Last Name:
CUCINOTTA
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
B
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
513-867-2834

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  35058438 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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