Provider Demographics
NPI:1225054877
Name:CUMBERLAND OBSTETRICS AND GYNECOLOGY PA
Entity Type:Organization
Organization Name:CUMBERLAND OBSTETRICS AND GYNECOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-690-1025
Mailing Address - Street 1:PO BOX 173
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-0173
Mailing Address - Country:US
Mailing Address - Phone:856-690-1025
Mailing Address - Fax:856-690-1352
Practice Address - Street 1:1102 E CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-5002
Practice Address - Country:US
Practice Address - Phone:856-690-1025
Practice Address - Fax:856-690-1352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ010711900OtherAMERIHEALTH
NJG369945OtherOXFORD
NJ460864Medicare ID - Type Unspecified