Provider Demographics
NPI:1205899895
Name:CUSHER, ANDREW JAY (DPM)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JAY
Last Name:CUSHER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3377 COMPTON RD
Mailing Address - Street 2:140
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251-2506
Mailing Address - Country:US
Mailing Address - Phone:513-385-9236
Mailing Address - Fax:513-385-9236
Practice Address - Street 1:3377 COMPTON RD
Practice Address - Street 2:140
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251-2506
Practice Address - Country:US
Practice Address - Phone:513-385-9236
Practice Address - Fax:513-385-9236
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.001899213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHT80483Medicare UPIN
OH0426266Medicare ID - Type Unspecified
OHCU0474751Medicare ID - Type Unspecified