Provider Demographics
NPI:1417341900
Name:CUSH, EVANGELIA JOSEPHINE (BSW)
Entity Type:Individual
Prefix:MRS
First Name:EVANGELIA
Middle Name:JOSEPHINE
Last Name:CUSH
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 PIERPONT PLACE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314
Mailing Address - Country:US
Mailing Address - Phone:347-733-9393
Mailing Address - Fax:
Practice Address - Street 1:20 PIERPONT PL
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-5945
Practice Address - Country:US
Practice Address - Phone:347-733-9393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management