MEDICARE: DR CUTUGNO ONCOLOGY AND HEMATOLOGY SPECIALIST PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	210263	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396790952
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR CUTUGNO ONCOLOGY AND HEMATOLOGY SPECIALIST PLLC

Provider Business Mailing Address
First Line	:	105 MARYS AVE
Second Line	:	SUITE 1
City	:	KINGSTON
State	:	NY
Zip	:	12401-5848
Country	:	US
Telephone Number	:	845-340-2100
Fax Number	:	845-340-0202

Provider Business Practice Location Address
First Line	:	105 MARYS AVE
Second Line	:	SUITE 1
City	:	KINGSTON
State	:	NY
Zip	:	12401-5848
Country	:	US
Telephone Number	:	845-340-2100
Fax Number	:	845-340-0202

Authorized Official
Title or Position	:	SOLE MBR
Name	:	DR. ALFONSO CUTUGNO
Credential	:	MD
Telephone Number	:	845-340-2100

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	06/28/2012

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