Healthcare Provider Details

I. General information

NPI: 1982240768
Provider Name (Legal Business Name): MONICA J CUYA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2019
Last Update Date: 11/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

998 CROOKED HILL RD
BRENTWOOD NY
11717-1019
US

IV. Provider business mailing address

5306 TOWNE WOODS RD
CORAM NY
11727-2808
US

V. Phone/Fax

Practice location:
  • Phone: 631-761-2306
  • Fax:
Mailing address:
  • Phone: 631-708-6970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number590456
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: