Organization
DR. JAY ERIC CUNNINGHAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY ERIC CUNNINGHAM D.P.M. (PODIATRIST)
(724) 626-7620
Entity
Organization
Contact information
Practice address
2616 MEMORIAL BLVD STE D, CONNELLSVILLE, PA 15425-1418
(724) 626-7620
Mailing address
2616 MEMORIAL BLVD, SUITE D, CONNELLSVILLE, PA 15425-1418
(724) 626-7620
(724) 626-1338
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
SC004557R
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4423850001
PTAN
PA
Enumeration date
01/10/2008
Last updated
08/26/2015
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