Provider Demographics
NPI:1083658256
Name:KUO, CINDY (MD)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:KUO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 HEATHER LN
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3898
Mailing Address - Country:US
Mailing Address - Phone:856-778-5613
Mailing Address - Fax:
Practice Address - Street 1:2230 COTTMAN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149-1230
Practice Address - Country:US
Practice Address - Phone:215-685-0639
Practice Address - Fax:215-725-4877
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD072637L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF63546Medicare UPIN
NJ079210Medicare ID - Type Unspecified