Healthcare Provider Details

I. General information

NPI: 1639107048
Provider Name (Legal Business Name): THOMAS F CUOMO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 07/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 1ST ST
SOUTH ORANGE NJ
07079-1900
US

IV. Provider business mailing address

61 FIRST STREET
SO ORANGE NJ
07079
US

V. Phone/Fax

Practice location:
  • Phone: 973-762-8344
  • Fax: 973-762-1626
Mailing address:
  • Phone: 973-762-8344
  • Fax: 973-762-1626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMA02971900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: