Provider Demographics
NPI:1437390218
Name:MARIA CUDA, DO, PC
Entity Type:Organization
Organization Name:MARIA CUDA, DO, PC
Other - Org Name:ST ALPHONSUS FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CUDA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:315-764-1444
Mailing Address - Street 1:PO BOX 610
Mailing Address - Street 2:
Mailing Address - City:MASSENA
Mailing Address - State:NY
Mailing Address - Zip Code:13662-0610
Mailing Address - Country:US
Mailing Address - Phone:315-764-1444
Mailing Address - Fax:315-764-1440
Practice Address - Street 1:15 HOSPITAL DR STE B
Practice Address - Street 2:
Practice Address - City:MASSENA
Practice Address - State:NY
Practice Address - Zip Code:13662-1037
Practice Address - Country:US
Practice Address - Phone:315-764-1444
Practice Address - Fax:315-764-1440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-09
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty