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General NPI Number Information
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NPI Number | 1841501764
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Entity Type | Individual
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Provider Name | JASON RONALD CUMBERS M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/24/2010
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 34 MARCONI ST STE 260
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City | BRONX
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State | NY
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Zip | 10461-2755
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Country | US
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Telephone | 668-607-2308
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Fax |
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Provider Business Mailing Address
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Address Line | 48 HILLCREST AVE
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City | BERKELEY HEIGHTS
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State | NJ
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Zip | 07922-1918
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Country | US
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Telephone | 718-288-6821
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 25MA09704200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 51036
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 325797
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License Number State | NY
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