Provider Demographics
NPI:1891722047
Name:CUMBO, EDWARD J (DO)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:J
Last Name:CUMBO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1800 SULLIVAN TRL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-8397
Mailing Address - Country:US
Mailing Address - Phone:610-250-8799
Mailing Address - Fax:610-829-1183
Practice Address - Street 1:1800 SULLIVAN TRL
Practice Address - Street 2:SUITE 200
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18040-8397
Practice Address - Country:US
Practice Address - Phone:610-250-8799
Practice Address - Fax:610-829-1183
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2014-09-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMB33444207Q00000X
PAOS003690L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00211963OtherRAILROAD MEDICARE
NJP00211963OtherRAILROAD MEDICARE
C52958Medicare UPIN