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NPI Code Detail

MEDICARE: MR. PETER ANTHONY CUDNEY LICSW

MEDICARE: MR. PETER ANTHONY CUDNEY LICSW
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
11041C0700XClinical Social Worker089.0058435VT

General Provider Information

NPI Number : 1083914782
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PETER ANTHONY CUDNEY LICSW
Provider Business Mailing Address
First Line : 30 AIRPORT RD
Second Line :
City : SOUTH BURLINGTON
State : VT
Zip : 05403-6432
Country : US
Telephone Number : 802-658-2441
Fax Number : 802-864-3857
Provider Business Practice Location Address
First Line : 30 AIRPORT RD
Second Line :
City : SOUTH BURLINGTON
State : VT
Zip : 05403-6432
Country : US
Telephone Number : 802-658-2441
Fax Number : 802-864-3857
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2010
Last Update Date : 10/27/2010

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