| Gerard J. Cusa M.d., Pllc | |
|
400 S Oyster Bay Rd Suite 302 Hicksville NY 11801-3500 | |
| (516) 939-0164 | |
| (516) 939-0165 |
| Full Name | Gerard J. Cusa M.d., Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 400 S Oyster Bay Rd, Hicksville, New York |
| Authorized Official Name and Position | Gerard J. Cusa (OWNER) |
| Authorized Official Contact | 5169390164 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gerard J. Cusa M.d., Pllc 400 S Oyster Bay Rd Suite 302 Hicksville NY 11801-3500 Ph: (516) 939-0164 | Gerard J. Cusa M.d., Pllc 400 S Oyster Bay Rd Suite 302 Hicksville NY 11801-3500 Ph: (516) 939-0164 |
| NPI Number | 1104176312 |
|---|---|
| Provider Enumeration Date | 09/14/2012 |
| Last Update Date | 10/13/2015 |
| Medicare PECOS PAC ID | 4880846575 |
|---|---|
| Medicare Enrollment ID | O20121203000412 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104176312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 156842 (New York) | Primary |
| Provider Name | Gerard J Cusa |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619017910 PECOS PAC ID: 3072765262 Enrollment ID: I20121217000188 |
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