Provider Demographics
NPI:1437605607
Name:CUCUZZA, JOHN (TEACHER)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:CUCUZZA
Suffix:
Gender:M
Credentials:TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:574 4TH AVE
Mailing Address - Street 2:APARTMENT 7D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-6363
Mailing Address - Country:US
Mailing Address - Phone:917-647-2238
Mailing Address - Fax:347-384-2797
Practice Address - Street 1:574 4TH AVE
Practice Address - Street 2:APARTMENT 7D
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-6363
Practice Address - Country:US
Practice Address - Phone:917-647-2238
Practice Address - Fax:347-384-2797
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist