Individual provider Active NPI

Eileen R Cusick, APRN

  • Adult Health Nurse Practitioner
  • Hartford, CT
National Provider Identifier
1679674584
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
001067 Issued in CT
Practice address
80 Seymour Street
Hartford Hospital Cardiology Dept
Hartford, CT 06102
Phone
(860) 545-1506
NPI assigned
Sep 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 001067 CT Primary

Addresses

Primary practice location

80 Seymour Street
Hartford Hospital Cardiology Dept
Hartford, CT 06102

Mailing address

Hartford Hospital Professional Services
PO Box 40,000 Dept634
Hartford, CT 06151-0634
Phone (860) 545-7602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1067CTMDOptometrist
001067CTMDNeurorehabilitation Occupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1679674584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HARTFORD HOSPITAL PROFESSIONAL SERVICES",
            "address_2": "PO BOX 40,000 DEPT634",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061510634",
            "telephone_number": "860-545-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR STREET",
            "address_2": "HARTFORD HOSPITAL CARDIOLOGY DEPT",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06102",
            "telephone_number": "860-545-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSICK",
        "first_name": "EILEEN",
        "middle_name": "R",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "001067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.