Provider Demographics
NPI:1871787663
Name:CUSCHIERI, JUSTIN R (MD)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:R
Last Name:CUSCHIERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4225 HOYT AVENUE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98205-2318
Mailing Address - Country:US
Mailing Address - Phone:425-259-3122
Mailing Address - Fax:425-322-2057
Practice Address - Street 1:4225 HOYT AVENUE
Practice Address - Street 2:STE A
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-2318
Practice Address - Country:US
Practice Address - Phone:425-259-3122
Practice Address - Fax:425-322-2057
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHNONE207R00000X
PAMT196537207RG0100X
DCMD041204207RG0100X
PAMD441342207RG0100X
WAMD60430435207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine