Provider Demographics
NPI:1205992377
Name:CUTE, DAWN (DC)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:
Last Name:CUTE
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 1:8945 RIDGE AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-2036
Mailing Address - Country:US
Mailing Address - Phone:215-508-3291
Mailing Address - Fax:215-508-3022
Practice Address - Street 1:8945 RIDGE AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-2036
Practice Address - Country:US
Practice Address - Phone:215-508-3291
Practice Address - Fax:215-508-3022
Is Sole Proprietor?:No
Enumeration Date:2006-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC 006969 L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2073300000OtherKEYSTONE HPE AND KEYSTONE
PA202098201OtherAETNA - CORPORATE TAX ID.
PA747769OtherIBC
PA2073300000OtherKEYSTONE HPE AND KEYSTONE