Provider Demographics
NPI:1992798755
Name:CUZZANITI, RAYMOND S (DO)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:S
Last Name:CUZZANITI
Suffix:
Gender:M
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:11781 LEE JACKSON MEMORIAL HWY
Mailing Address - Street 2:SUITE 550
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-3309
Mailing Address - Country:US
Mailing Address - Phone:571-777-5102
Mailing Address - Fax:703-563-6256
Practice Address - Street 1:325 S BELMONT ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-2608
Practice Address - Country:US
Practice Address - Phone:717-849-5781
Practice Address - Fax:717-815-2722
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2016-05-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PA05007682L207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001257994Medicaid
PA690173Medicare PIN
PAF03614Medicare UPIN