Provider Demographics
NPI:1265825525
Name:FORTE, CYNTHIA L (RN,LMT)
Entity Type:Individual
Prefix:MISS
First Name:CYNTHIA
Middle Name:L
Last Name:FORTE
Suffix:
Gender:F
Credentials:RN,LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:HAMPDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01036-9751
Mailing Address - Country:US
Mailing Address - Phone:413-219-8778
Mailing Address - Fax:413-599-1963
Practice Address - Street 1:10 ALLEN ST
Practice Address - Street 2:
Practice Address - City:HAMPDEN
Practice Address - State:MA
Practice Address - Zip Code:01036-9751
Practice Address - Country:US
Practice Address - Phone:413-219-8778
Practice Address - Fax:413-599-1963
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN213822163WH1000X
MALMT 11778175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No163WH1000XNursing Service ProvidersRegistered NurseHospice