Cusack, Carrie Ann R
Cusack, Carrie Ann R is an individual health care provider with primary practice located at 219 N Broad St 4Th Floor, Philadelphia PA 19107-1519. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Cusack, Carrie Ann R can be contacted via phone (215) 762-5550.Contact Information
Primary practice address
219 N Broad St 4Th Floor
Philadelphia PA 19107-1519
Phone: (215) 762-5550
Fax: (215) 762-5570
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | MD422137 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ND0900X | MD422137 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 25MA07815500 | New Jersey |
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ND0900X | 25MA07815500 | New Jersey |
Profile Details
| NPI number | 1649238775 |
|---|---|
| LBN Legal business name | Cusack, Carrie Ann R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 1st, 2006 |
| Last updated | Aug 31st, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649238775 | NPPES |
| Pennsylvania | MEDICAID | 001967148 |
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