Louis A Cuccaro, DC
Individual provider Active NPI Chiropractor · West Long Branch, NJ
NPI 1720161664 · NPPES record last updated Oct 1, 2009
Key facts
- NPI
- 1720161664
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 38MC00131000 (NJ)
- Practice address
- 1049 Broadway
West Long Branch, NJ 07764-1334 - Phone
- (732) 571-1177
- Fax
- (732) 571-4958
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38MC00131000 | NJ | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38MC00131000 | NJ | Yes |
Addresses
Primary practice location
1049 Broadway
West Long Branch, NJ 07764-1334
Mailing address
1049 Broadway
West Long Branch, NJ 07764-1334
Phone (732) 571-1177
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2041804 | Medicaid | NJ |
Other providers in West Long Branch, NJ
- Seth D Cohen
- Community Options, Inc
- Natalie M Cortez
- Crest Physical Therapy Services
- Crest West Long Branch Physical Therapy PA
- Trina Cunningham
- Michele Czechowski
- Mary L Dalessandro
- Justina Daley
- Robert James Damurjian
All providers in West Long Branch, NJ · Chiropractor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.