Basic Information
| Provider Information | |||||||||
| NPI: | 1629045844 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CUSHNER | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 73 MARKET ST | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | YONKERS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 107107602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146826540 | ||||||||
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| Practice Location | |||||||||
| Address1: | 73 MARKET ST | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | YONKERS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 107107602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146826540 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2006 | ||||||||
| LastUpdateDate: | 10/16/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 220481 | NY | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 02155342 | 05 | NY | MEDICAID |