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Individual

DR. PHILLIP J CUSANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
116 INTERSTATE PKWY, BRADFORD, PA 16701-1036
(814) 362-8674
Mailing address
908 NIAGARA FALLS BLVD, SUITE 208, NORTH TONAWANDA, NY 14120-2019
(716) 692-2160
(716) 332-3525

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
234708
NY
207L00000X
Anesthesiology Physician
Primary
MD435560
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1012850420
PA
Enumeration date
01/27/2006
Last updated
08/27/2013
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