Healthcare Provider Details

I. General information

NPI: 1033153408
Provider Name (Legal Business Name): ANTHONY JOHN CUOMO PT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 HOMESTEAD RD
HILLSBOROUGH NJ
08844-1400
US

IV. Provider business mailing address

228 2ND ST
FANWOOD NJ
07023-1631
US

V. Phone/Fax

Practice location:
  • Phone: 908-281-6515
  • Fax: 908-281-6268
Mailing address:
  • Phone: 908-889-6525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number40QA04492
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: