Provider Demographics
NPI:1437229622
Name:DUMOND, CYNTHIA ROBIN (RN)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ROBIN
Last Name:DUMOND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 CHERRY TREE CIR
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-2450
Mailing Address - Country:US
Mailing Address - Phone:315-516-3961
Mailing Address - Fax:315-506-6698
Practice Address - Street 1:36 CHERRY TREE CIR
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13090-2450
Practice Address - Country:US
Practice Address - Phone:315-516-3961
Practice Address - Fax:315-506-6698
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5589181163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01996294Medicaid