MEDICARE: ANGEL CUFFIE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency	9402	VA

General Provider Information

NPI Number	:	1033989959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGEL CUFFIE

Provider Business Mailing Address
First Line	:	4037 MIDDLEBURG LN
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23321-1866
Country	:	US
Telephone Number	:	757-560-7591
Fax Number	:

Provider Business Practice Location Address
First Line	:	4037 MIDDLEBURG LN
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23321-1866
Country	:	US
Telephone Number	:	757-560-7591
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2024
Last Update Date	:	01/16/2024

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