Provider Demographics
NPI:1043736796
Name:CUSANELLI, ANTHONY M (CNIM)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:M
Last Name:CUSANELLI
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Gender:M
Credentials:CNIM
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Mailing Address - Street 1:307 S HENRY ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-5900
Mailing Address - Country:US
Mailing Address - Phone:410-983-9246
Mailing Address - Fax:410-995-2124
Practice Address - Street 1:6600 YORK RD STE 210
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-2024
Practice Address - Country:US
Practice Address - Phone:410-983-9246
Practice Address - Fax:410-995-2124
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2022-07-21
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic