Provider Demographics
NPI:1114084621
Name:CUOMO, CARMELA (DC)
Entity type:Individual
Prefix:DR
First Name:CARMELA
Middle Name:
Last Name:CUOMO
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 1:2143 WILLIAMSBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1601
Mailing Address - Country:US
Mailing Address - Phone:718-863-1600
Mailing Address - Fax:718-863-5555
Practice Address - Street 1:2143 WILLIAMSBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1601
Practice Address - Country:US
Practice Address - Phone:718-863-1600
Practice Address - Fax:718-863-5555
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009782-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX4X321Medicare ID - Type Unspecified