Provider Demographics
NPI:1578896114
Name:CIRILLO, CINDY (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:CIRILLO
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 3RD ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-3906
Mailing Address - Country:US
Mailing Address - Phone:518-274-8181
Mailing Address - Fax:518-272-8164
Practice Address - Street 1:42 3RD ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-3906
Practice Address - Country:US
Practice Address - Phone:518-274-8181
Practice Address - Fax:518-274-8181
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005086-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician