Provider Demographics
NPI:1255390415
Name:CUYJET, ALOYSIUS BAXTER (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:ALOYSIUS
Middle Name:BAXTER
Last Name:CUYJET
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 WALNUT ROAD
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542
Mailing Address - Country:US
Mailing Address - Phone:516-404-0349
Mailing Address - Fax:516-676-5253
Practice Address - Street 1:2201 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1859
Practice Address - Country:US
Practice Address - Phone:516-572-6501
Practice Address - Fax:516-572-5609
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118428-1207R00000X, 207RC0000X, 207RC0200X
NY118428207R00000X, 207RC0000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00344490Medicaid
NYCU55115Medicare UPIN
NYC55115Medicare UPIN
NY00344490Medicaid