MEDICARE: COURTNEY CUCCIA

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	367500000X	Certified Registered Nurse Anesthetist	RN611442	PA

General Provider Information

NPI Number	:	1497149710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY CUCCIA

Provider Business Mailing Address
First Line	:	161 SHEARER RD
Second Line	:
City	:	NEW KENSINGTON
State	:	PA
Zip	:	15068-9320
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	161 SHEARER RD
Second Line	:
City	:	NEW KENSINGTON
State	:	PA
Zip	:	15068-9320
Country	:	US
Telephone Number	:	724-612-3758
Fax Number	:

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

Provider Enumeration Date	:	03/25/2015
Last Update Date	:	01/03/2018

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Directions to “ COURTNEY CUCCIA ” Practice Location

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