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Organization

LAWRENCE MICHAEL CUSMA, OD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LAWRENCE MICHAEL CUSMA O.D. (OWNER/OPTOMETRIST)
(518) 399-6368
Entity
Organization

Contact information

Practice address
9 GLEASON RD, SCOTIA, NY 12302-5307
(518) 399-6368
(518) 399-6372
Mailing address
9 GLEASON RD, SCOTIA, NY 12302-5307
(518) 399-6368
(518) 399-6372

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV003340-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10000423
CAPITAL DISTRICT PHYSICIANS HEALTH PLAN
NY
01
59127
MVP HEALTH PLAN
NY
Enumeration date
03/28/2014
Last updated
09/29/2016
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