Provider Demographics
NPI:1457320335
Name:CYR, EDWARD ODILON (CRNA, MSN)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:ODILON
Last Name:CYR
Suffix:
Gender:M
Credentials:CRNA, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 FRANCA DR
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:RI
Mailing Address - Zip Code:02809-4712
Mailing Address - Country:US
Mailing Address - Phone:401-254-2618
Mailing Address - Fax:
Practice Address - Street 1:47 FRANCA DR
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:RI
Practice Address - Zip Code:02809-4712
Practice Address - Country:US
Practice Address - Phone:401-254-2618
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA130129367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered