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NPI Code Detail

MEDICARE: ELIZABETH CUSACK

MEDICARE: ELIZABETH CUSACK
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
1163W00000XRegistered NurseRN10010673MA

General Provider Information

NPI Number : 1700717220
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH CUSACK
Provider Business Mailing Address
First Line : 940 BELMONT ST
Second Line :
City : BROCKTON
State : MA
Zip : 02301-5596
Country : US
Telephone Number : 800-865-3384
Fax Number : 774-826-2826
Provider Business Practice Location Address
First Line : 940 BELMONT ST
Second Line :
City : BROCKTON
State : MA
Zip : 02301-5596
Country : US
Telephone Number : 800-865-3384
Fax Number : 774-826-2826
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2026
Last Update Date : 05/25/2026

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Directions to “ ELIZABETH CUSACK ” Practice Location

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