Provider Demographics
NPI:1689604357
Name:BRINK-CYMERMAN, DAWN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:MARIE
Last Name:BRINK-CYMERMAN
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 1:5112 WEST TAFT ROAD
Mailing Address - Street 2:SUITE L
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088
Mailing Address - Country:US
Mailing Address - Phone:315-452-2500
Mailing Address - Fax:315-452-2510
Practice Address - Street 1:132 1/2 ALBANY STREET
Practice Address - Street 2:
Practice Address - City:CAZENOVIZ
Practice Address - State:NY
Practice Address - Zip Code:13035
Practice Address - Country:US
Practice Address - Phone:315-655-8171
Practice Address - Fax:315-655-5923
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237812207Q00000X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2735495Medicaid
NYRA8775Medicare PIN
NYRA2723Medicare PIN
NY2735495Medicaid
NYRA8850Medicare PIN