Provider Demographics
NPI:1609869734
Name:CUCCO, VALERIE (DO)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:CUCCO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:VALERIE
Other - Middle Name:M
Other - Last Name:CUCCO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:120 MINEOLA BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4073
Mailing Address - Country:US
Mailing Address - Phone:516-663-3010
Mailing Address - Fax:516-663-3026
Practice Address - Street 1:120 MINEOLA BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4073
Practice Address - Country:US
Practice Address - Phone:516-663-3010
Practice Address - Fax:516-663-3026
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY163860207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01576636Medicaid
NY01576636Medicaid
G05646Medicare UPIN