Elizabeth Cusick
MOHS-Micrographic Surgeon
75 N Country Rd
Port Jefferson
, New York 11777-2119
Elizabeth Cusick
MOHS-Micrographic Surgeon
75 N Country Rd
Port Jefferson
, New York 11777-2119
(718) 354-5936
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About
Features
Specialties
- MOHS-Micrographic Surgeon
Languages spoken
- English
Location
First Address
- Elizabeth Cusick
- 8 Flax Pond Woods Rd
- Setauket, NY
- Zip : 11733-1641
- Phone : (718) 354-5936
Second Address
- Elizabeth Cusick
- 75 N Country Rd
- Port Jefferson, NY
- Zip : 11777-2119
- Fax : (631) 686-7651
- Phone : (631) 686-2549
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207ND0101X | MOHS-Micrographic Surgeon | MD-48258 | IA |
National Provider Identifier
| NPI | 1033641196 |
|---|---|
| Provider Name | Elizabeth Cusick |
| First Address | Setauket, NY 11733-1641 |
| Second Address | Port Jefferson, NY 11777-2119 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/03/2017 |
| Last Update Date | 02/03/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.