Provider Demographics
NPI:1528492238
Name:CUEVAS, ANNA C
Entity type:Individual
Prefix:MISS
First Name:ANNA
Middle Name:C
Last Name:CUEVAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 918
Mailing Address - Street 2:
Mailing Address - City:UPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11973-0918
Mailing Address - Country:US
Mailing Address - Phone:631-816-9089
Mailing Address - Fax:
Practice Address - Street 1:271 LAKE POINTE CIR
Practice Address - Street 2:
Practice Address - City:MIDDLE ISLAND
Practice Address - State:NY
Practice Address - Zip Code:11953-2062
Practice Address - Country:US
Practice Address - Phone:631-816-9089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY692028121174400000X
NY692027121174400000X
NY692219121174400000X
NY692026121174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist