Individual
DR. STEPHEN VINCENT CUSUMANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TO2670
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831192533
NPI
—
01
—
431081796
FEDERAL TAX ID
MO
01
—
91710001
PTAN
—
Enumeration date
05/27/2005
Last updated
10/20/2025
Update your record
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