Individual
MR. JEFFREY J. CUSACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1172 5TH AVE, EAST NORTHPORT, NY 11731-2631
(631) 266-2220
(631) 266-5119
Mailing address
1172 5TH AVE, EAST NORTHPORT, NY 11731-2631
(631) 266-2220
(631) 266-5119
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N003228-1
NY
Other
Enumeration date
07/21/2005
Last updated
12/28/2007
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