Provider Demographics
NPI:1710204052
Name:REYNOLDS TREMBLAY, CINDY LEE (RN)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:LEE
Last Name:REYNOLDS TREMBLAY
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 1:229 COUNTY ROUTE 42
Mailing Address - Street 2:
Mailing Address - City:FORT COVINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:12937-2505
Mailing Address - Country:US
Mailing Address - Phone:518-358-9612
Mailing Address - Fax:
Practice Address - Street 1:229 COUNTY ROUTE 42
Practice Address - Street 2:
Practice Address - City:FORT COVINGTON
Practice Address - State:NY
Practice Address - Zip Code:12937-2505
Practice Address - Country:US
Practice Address - Phone:518-358-9612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY440960-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse