MEDICARE: GARY A CUCCIA DC

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	111N00000X	Chiropractor	DC005558L	PA

General Provider Information

NPI Number	:	1508822156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY A CUCCIA DC

Provider Business Mailing Address
First Line	:	PO BOX 768
Second Line	:
City	:	NEW ALEXANDRIA
State	:	PA
Zip	:	15670
Country	:	US
Telephone Number	:	724-668-7772
Fax Number	:	724-668-8732

Provider Business Practice Location Address
First Line	:	3223 ROUTE 119
Second Line	:
City	:	NEW ALEXANDRIA
State	:	PA
Zip	:	15670
Country	:	US
Telephone Number	:	724-668-7772
Fax Number	:	724-668-8732

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

Provider Enumeration Date	:	04/24/2006
Last Update Date	:	07/08/2007

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Directions to “ GARY A CUCCIA DC” Practice Location

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