Provider Demographics
NPI:1316212657
Name:CUSUMANO, BARBARA ANN
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:CUSUMANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:ANN
Other - Last Name:CUSUMANO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:4 MEYER AVE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1006
Mailing Address - Country:US
Mailing Address - Phone:718-769-3498
Mailing Address - Fax:718-648-7816
Practice Address - Street 1:2525 HARING ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-1655
Practice Address - Country:US
Practice Address - Phone:718-769-3498
Practice Address - Fax:718-648-7816
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338594163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse