Provider Demographics
NPI:1073965323
Name:ANTI, CYNTHIA II
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:ANTI
Suffix:II
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 WILLIAM ST
Mailing Address - Street 2:APT 2B
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-3132
Mailing Address - Country:US
Mailing Address - Phone:718-690-0855
Mailing Address - Fax:
Practice Address - Street 1:80 WILLIAM ST
Practice Address - Street 2:APT 2B
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10552-3132
Practice Address - Country:US
Practice Address - Phone:718-690-0855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY325670164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse