Provider Demographics
NPI:1417992637
Name:CIMINO, ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:CIMINO
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 1:2 STONE HARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2138
Mailing Address - Country:US
Mailing Address - Phone:609-463-2339
Mailing Address - Fax:
Practice Address - Street 1:2 STONE HARBOR BOULEVARD
Practice Address - Street 2:BURDETTE TOMLIN MEMORIAL HOSPITAL EMERGENCY DEPARTMENT
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210
Practice Address - Country:US
Practice Address - Phone:609-463-2339
Practice Address - Fax:609-463-2946
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA0784100207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0077585Medicaid
NJ093418Medicare ID - Type Unspecified
I39000Medicare UPIN