Healthcare Provider Details

I. General information

NPI: 1982519203
Provider Name (Legal Business Name): ADRIAN SERGIO CUELLO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 GREEN FARMS RD
GREEN TOWNSHIP NJ
07821-2004
US

IV. Provider business mailing address

14 GREEN FARMS RD
GREEN TOWNSHIP NJ
07821-2004
US

V. Phone/Fax

Practice location:
  • Phone: 908-343-0556
  • Fax:
Mailing address:
  • Phone: 908-343-0556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number13VH04567200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: