Healthcare Provider Details

I. General information

NPI: 1982730453
Provider Name (Legal Business Name): RICK CHARLES CUOMO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 GLENVILLE RD GROUND FLOOR
GREENWICH CT
06831-4172
US

IV. Provider business mailing address

239 GLENVILLE RD GROUND FLOOR
GREENWICH CT
06831-4172
US

V. Phone/Fax

Practice location:
  • Phone: 203-531-9191
  • Fax: 203-532-9194
Mailing address:
  • Phone: 203-531-9191
  • Fax: 203-532-9194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number000749
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: