Healthcare Provider Details

I. General information

NPI: 1730253840
Provider Name (Legal Business Name): BERNICE CUSCUNA MS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 07/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 ROUTE 130 ZAFFERESE PT
EAST WINDSOR NJ
08520-2792
US

IV. Provider business mailing address

95 MANSION AVE
STATEN ISLAND NY
10308-3524
US

V. Phone/Fax

Practice location:
  • Phone: 609-918-0600
  • Fax: 609-918-0601
Mailing address:
  • Phone: 718-568-4148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0211641
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00868300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: