Provider Demographics
NPI:1518102805
Name:CUETO, CHRIS GERARD BAUN (DC)
Entity type:Individual
Prefix:DR
First Name:CHRIS GERARD
Middle Name:BAUN
Last Name:CUETO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13704 GUY R BREWER BLVD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-3731
Mailing Address - Country:US
Mailing Address - Phone:516-606-7326
Mailing Address - Fax:
Practice Address - Street 1:13704 GUY R BREWER BLVD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-3731
Practice Address - Country:US
Practice Address - Phone:516-606-7326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011623111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111N00000XChiropractic ProvidersChiropractor