Healthcare Provider Details

I. General information

NPI: 1114918976
Provider Name (Legal Business Name): ROSE MARY KAW CUASUI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8330 VIETOR AVE STE 102
ELMHURST NY
11373-3260
US

IV. Provider business mailing address

8330 VIETOR AVE STE 102
ELMHURST NY
11373-3260
US

V. Phone/Fax

Practice location:
  • Phone: 718-507-8887
  • Fax: 718-507-1024
Mailing address:
  • Phone: 718-507-8887
  • Fax: 718-507-1024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number046547
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: