Provider Demographics
NPI:1487716841
Name:CUOCO, ANTHONY JR
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:
Last Name:CUOCO
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:582 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5436
Mailing Address - Country:US
Mailing Address - Phone:718-499-2616
Mailing Address - Fax:718-499-0440
Practice Address - Street 1:582 5TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-5436
Practice Address - Country:US
Practice Address - Phone:718-499-2616
Practice Address - Fax:718-499-0440
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY36876183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist