Individual
DOMINIC CUSATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
225 E CITY AVE STE 10, BALA CYNWYD, PA 19004-1724
(215) 503-3838
Mailing address
1304 S 36TH ST, PHILADELPHIA, PA 19146-3204
(856) 759-9384
Taxonomy
Speciality
Code
Description
License number
State
364SF0001X
Family Health Clinical Nurse Specialist
Primary
SP28425
PA
Other
Enumeration date
11/11/2025
Last updated
11/11/2025
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