Healthcare Provider Details

I. General information

NPI: 1316171572
Provider Name (Legal Business Name): DANIEL ADAM CUZZONE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2009
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

THE EMORY CLINIC INC 1365 CLIFTON RD NE
ATLANTA GA
30368-2913
US

IV. Provider business mailing address

12 YEW ST
NORWALK CT
06850-1231
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-4500
  • Fax:
Mailing address:
  • Phone: 203-856-0680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number277081
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number81027
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: