Doctor Name: | DR. CROMWELL PETER MSUKU |
NPI Number: | 1003969759 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | |
Business Practice Address: | 1500 Broadway St Buffalo, NY - 142121845 |
Business Phone Number: | 7168930062 |
Business Fax Number: | 7168930070 |
Mailing Address: | 1526 Walden Ave, Suite 400 CHEEKTOWAGA |
State: | NY |
Postal Code: | 142254965 |
Phone Number: | 7168957167 |
Fax Number: | 7163324488 |
NPI Enumeration Date: | 01/18/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |