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General NPI Number Information
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NPI Number | 1396790952
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Entity Type | Organization
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Legal Business Name | DR CUTUGNO ONCOLOGY AND HEMATOLOGY SPECIALIST PLLC
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 06/28/2012
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Provider Practice Location Address
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Address Line | 105 MARYS AVE SUITE 1
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City | KINGSTON
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State | NY
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Zip | 12401-5848
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Country | US
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Telephone | 845-340-2100
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Fax | 845-340-0202
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Provider Business Mailing Address
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Address Line | 105 MARYS AVE SUITE 1
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City | KINGSTON
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State | NY
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Zip | 12401-5848
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Country | US
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Telephone | 845-340-2100
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Fax | 845-340-0202
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Authorized Official
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Title or Position | SOLE MBR
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Name | DR. ALFONSO CUTUGNO
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Credential | MD
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Telephone | 845-340-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 210263
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License Number State | NY
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