Healthcare Provider Details

I. General information

NPI: 1255390415
Provider Name (Legal Business Name): ALOYSIUS BAXTER CUYJET MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 10/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 HEMPSTEAD TPKE
EAST MEADOW NY
11554-1859
US

IV. Provider business mailing address

90 WALNUT ROAD
GLEN COVE NY
11542
US

V. Phone/Fax

Practice location:
  • Phone: 516-572-6501
  • Fax: 516-572-5609
Mailing address:
  • Phone: 516-404-0349
  • Fax: 516-676-5253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number118428-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number118428-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number118428-1
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number118428
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number118428
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number118428
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: