Provider Demographics
NPI:1033153408
Name:CUOMO, ANTHONY JOHN (PT)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:JOHN
Last Name:CUOMO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 2ND ST
Mailing Address - Street 2:
Mailing Address - City:FANWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07023-1631
Mailing Address - Country:US
Mailing Address - Phone:908-889-6525
Mailing Address - Fax:
Practice Address - Street 1:427 HOMESTEAD RD
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-1400
Practice Address - Country:US
Practice Address - Phone:908-281-6515
Practice Address - Fax:908-281-6268
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA04492208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation