Provider Demographics
NPI:1659401719
Name:GREGORY J CUOZZO MD PC
Entity Type:Organization
Organization Name:GREGORY J CUOZZO MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CUOZZO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-349-4434
Mailing Address - Street 1:102 COMMONS WAY
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755
Mailing Address - Country:US
Mailing Address - Phone:732-349-4434
Mailing Address - Fax:732-349-9290
Practice Address - Street 1:102 COMMONS WAY
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755
Practice Address - Country:US
Practice Address - Phone:732-349-4434
Practice Address - Fax:732-349-9290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA68872207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJDE0957Medicare PIN
NJ043677Medicare PIN