Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 40QA00747700 | NJ |
NPI | 1003196395 |
---|---|
Provider Name | Danielle M. Cusimano |
First Address | Pompton Plains, NJ 07444-2100 |
Second Address | Pompton Plains, NJ 07444-2100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2011 |
Last Update Date | 26/03/2016 |