Provider Demographics
NPI:1437237807
Name:DICUIO, ROBERT FRANK (PHD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:FRANK
Last Name:DICUIO
Suffix:
Gender:M
Credentials:PHD
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 343
Mailing Address - Street 2:
Mailing Address - City:CRANBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08512-0343
Mailing Address - Country:US
Mailing Address - Phone:609-860-6455
Mailing Address - Fax:646-478-9229
Practice Address - Street 1:70 S MAIN ST
Practice Address - Street 2:SUITE 1C
Practice Address - City:CRANBURY
Practice Address - State:NJ
Practice Address - Zip Code:08512-3140
Practice Address - Country:US
Practice Address - Phone:609-860-6455
Practice Address - Fax:646-478-9229
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100215800103T00000X
NY68 006255103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6702406Medicaid
R51343Medicare UPIN