Healthcare Provider Details

I. General information

NPI: 1669631263
Provider Name (Legal Business Name): YOLANDA MARIA CUOMO RPA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 06/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259 1ST ST 3MAIN NEUROSCIENCE OFFICE
MINEOLA NY
11501-3957
US

IV. Provider business mailing address

259 FIRST STREET 3MAIN NEUROSCIENCE OFFICE
MINEOLA NY
11501
US

V. Phone/Fax

Practice location:
  • Phone: 516-663-3833
  • Fax:
Mailing address:
  • Phone: 516-663-3833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number007409
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: