Provider Demographics
NPI:1023362241
Name:MAY, CYNTHIA ROSS
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ROSS
Last Name:MAY
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:CYNTHIA
Other - Middle Name:ROSS
Other - Last Name:MAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:COTA
Mailing Address - Street 1:2791 UPPER MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:SANBORN
Mailing Address - State:NY
Mailing Address - Zip Code:14132-9315
Mailing Address - Country:US
Mailing Address - Phone:716-731-1966
Mailing Address - Fax:
Practice Address - Street 1:2791 UPPER MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:SANBORN
Practice Address - State:NY
Practice Address - Zip Code:14132-9315
Practice Address - Country:US
Practice Address - Phone:716-731-1966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002824-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist