Provider Demographics
NPI:1821858267
Name:CUSANO, BENJAMITR BERNARD
Entity Type:Individual
Prefix:
First Name:BENJAMITR
Middle Name:BERNARD
Last Name:CUSANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 GREEN RIVER RD
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-9707
Mailing Address - Country:US
Mailing Address - Phone:540-282-0477
Mailing Address - Fax:
Practice Address - Street 1:296 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-1932
Practice Address - Country:US
Practice Address - Phone:413-774-5411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator