Provider Demographics
NPI:1134185283
Name:CUVO, CARL J JR (PAC)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:J
Last Name:CUVO
Suffix:JR
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2597 SCHOENERSVILLE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017
Mailing Address - Country:US
Mailing Address - Phone:610-691-0973
Mailing Address - Fax:610-691-7882
Practice Address - Street 1:2597 SCHOENERSVILLE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017
Practice Address - Country:US
Practice Address - Phone:610-691-0973
Practice Address - Fax:610-691-7882
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA000260L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
R05975Medicare UPIN
PA083365LPBMedicare PIN