Provider Demographics
NPI:1376889543
Name:CUMELLA, JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:CUMELLA
Suffix:
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 1:521 ROOSEVELT WAY
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-6684
Mailing Address - Country:US
Mailing Address - Phone:516-333-8074
Mailing Address - Fax:516-333-8084
Practice Address - Street 1:521 ROOSEVELT WAY
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-6684
Practice Address - Country:US
Practice Address - Phone:516-333-8084
Practice Address - Fax:516-333-8084
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-17
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY083730-1207QA0505X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine