Individual
DR. KEVIN JAMES CUCCINELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 E JOHNSON ST, HOLYOKE, CO 80734-1854
(970) 854-2241
(970) 458-4581
Mailing address
1001 E JOHNSON ST, HOLYOKE, CO 80734-1854
(970) 854-2241
(970) 458-4581
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DR.0042299
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39532721
—
CO
01
—
DR.0042299
CO LICENSE NUMBER
CO
Enumeration date
01/23/2006
Last updated
02/10/2021
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