Provider Demographics
NPI:1518927367
Name:MANN, CYNTHIA F (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:F
Last Name:MANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2200 WHITNEY AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3691
Mailing Address - Country:US
Mailing Address - Phone:203-287-5400
Mailing Address - Fax:203-281-3001
Practice Address - Street 1:2200 WHITNEY AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3691
Practice Address - Country:US
Practice Address - Phone:203-287-5400
Practice Address - Fax:203-281-3001
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT20814208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001208149Medicaid
CT702814OtherCONNECTICARE
CT00120841900OtherBLUECARE FAMILY PLAN
CT0100208149CT02OtherANTHEM BLUE CROSS
CT0Q1366OtherHEALTHNET
CTNHP210OtherOXFORD
CT001208149Medicaid
CTNHP210OtherOXFORD