Provider Demographics
NPI:1578381216
Name:CUMMINGS, STEVEN CALVIN
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:CALVIN
Last Name:CUMMINGS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8770 DELL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-8700
Mailing Address - Country:US
Mailing Address - Phone:315-622-9620
Mailing Address - Fax:
Practice Address - Street 1:8770 DELL CENTER DR
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13090-8700
Practice Address - Country:US
Practice Address - Phone:315-622-9620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-01
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007201-01156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician