Provider Demographics
NPI:1881291441
Name:CUCUZZA, KATHERINE ELIZABETH (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:ELIZABETH
Last Name:CUCUZZA
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:ELIZABETH
Other - Last Name:RUFO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:19 DEERHURST RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-4714
Mailing Address - Country:US
Mailing Address - Phone:617-447-9177
Mailing Address - Fax:
Practice Address - Street 1:35 E GRASSY SPRAIN RD
Practice Address - Street 2:STE 102
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-4612
Practice Address - Country:US
Practice Address - Phone:914-652-7477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY346676363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily