Provider Demographics
NPI:1013982743
Name:CUNICO, SUSAN JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:JEAN
Last Name:CUNICO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 LAWRENCE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-2822
Mailing Address - Country:US
Mailing Address - Phone:973-948-7595
Mailing Address - Fax:973-948-7530
Practice Address - Street 1:12 LAWRENCE RD STE 201
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-2822
Practice Address - Country:US
Practice Address - Phone:973-948-7595
Practice Address - Fax:973-948-7530
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00421400111N00000X
NJ171100000X, 225XP0019X
NJ26NJ01260600202D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine
No111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ026160Medicare ID - Type Unspecified
O74651Medicare UPIN