Provider Demographics
NPI:1841501764
Name:CUMBERS, JASON RONALD (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:RONALD
Last Name:CUMBERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 HILLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-1918
Mailing Address - Country:US
Mailing Address - Phone:718-288-6821
Mailing Address - Fax:
Practice Address - Street 1:34 MARCONI ST STE 260
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2755
Practice Address - Country:US
Practice Address - Phone:668-607-2308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09704200208600000X
KY51036208600000X
NY3257972086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery