Healthcare Provider Details

I. General information

NPI: 1215821897
Provider Name (Legal Business Name): VINCENT CUEVAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 SPRUCE ST
PHILADELPHIA PA
19107-6192
US

IV. Provider business mailing address

1231 MORSTEIN RD
WEST CHESTER PA
19380-3611
US

V. Phone/Fax

Practice location:
  • Phone: 215-316-5151
  • Fax:
Mailing address:
  • Phone: 267-918-1444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberSP029137
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: