Healthcare Provider Details

I. General information

NPI: 1083658256
Provider Name (Legal Business Name): CINDY KUO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 08/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 COTTMAN AVE
PHILADELPHIA PA
19149-1230
US

IV. Provider business mailing address

3 HEATHER LN
MOORESTOWN NJ
08057-3898
US

V. Phone/Fax

Practice location:
  • Phone: 215-685-0639
  • Fax: 215-725-4877
Mailing address:
  • Phone: 856-778-5613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD072637L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: