Provider Demographics
NPI:1306855861
Name:CUNNINGHAM, ROBERT JR (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:CUNNINGHAM
Suffix:JR
Gender:M
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:PO BOX 15124
Mailing Address - Street 2:SUITE 509
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07192-5124
Mailing Address - Country:US
Mailing Address - Phone:973-673-4620
Mailing Address - Fax:
Practice Address - Street 1:185 CENTRAL AVE
Practice Address - Street 2:SUITE 509
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-3332
Practice Address - Country:US
Practice Address - Phone:973-673-4620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA-39692207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2643405Medicaid
NJ2643405Medicaid
NJ527589Medicare ID - Type Unspecified