Provider Demographics
NPI:1104191527
Name:SABLAH, CYNTHIA A (ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:A
Last Name:SABLAH
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:MRS
Other - First Name:CYNTHIA
Other - Middle Name:A
Other - Last Name:SABLAH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN-BC
Mailing Address - Street 1:51 OAKFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-1935
Mailing Address - Country:US
Mailing Address - Phone:516-771-6307
Mailing Address - Fax:
Practice Address - Street 1:4802 10TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2916
Practice Address - Country:US
Practice Address - Phone:718-283-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305702-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health