Provider Information for 1346746161
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ANTONIO CUSANO MD
Sex: Male
NPI: 1346746161
Last Updated: 2024-08-26
Certification Date: 2024-08-26
Certification Date: 2024-08-26
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1346746161 | ||||||||||||
| Enumeration Date | 2018-04-02 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 263 FARMINGTON AVE FARMINGTON, CT 06030-8082 United States Phone: 860-679-6600 | Fax:860-679-6604 | ||||||||||||
| Primary Practice Address | 263 FARMINGTON AVE FARMINGTON, CT 06030-4038 United States Phone: 860-679-6600 | Fax:860-679-6604 | ||||||||||||
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