Individual
DEBORAH K CUSACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
519 W 114TH ST, NEW YORK, NY 10027-7036
(212) 854-7390
Mailing address
91 MIDDLE RD, EASTCHESTER, NY 10709-3843
(914) 793-6127
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F302192
NY
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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