Provider Demographics
NPI:1326001892
Name:ANNESKI, CYNTHIA JEAN (MD)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:JEAN
Last Name:ANNESKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1731
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85299-1731
Mailing Address - Country:US
Mailing Address - Phone:480-426-1566
Mailing Address - Fax:480-275-3538
Practice Address - Street 1:1452 N HIGLEY RD STE 101
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-1610
Practice Address - Country:US
Practice Address - Phone:480-426-1566
Practice Address - Fax:480-275-3538
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24757207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ387995OtherAHCCCS
ZMD24757Medicare PIN
AZ387995OtherAHCCCS