Provider Demographics
NPI:1821045766
Name:MYERS, CYNTHIA E (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:E
Last Name:MYERS
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 1:464 WEST 145 STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031
Mailing Address - Country:US
Mailing Address - Phone:212-926-5050
Mailing Address - Fax:212-926-7778
Practice Address - Street 1:464 WEST 145 STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031
Practice Address - Country:US
Practice Address - Phone:212-926-5050
Practice Address - Fax:212-926-7778
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185152207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01381662Medicaid
NYP00639791OtherRAILROAD MEDICARE GROUP MEMBER PTAN
NYP00639791OtherRAILROAD MEDICARE GROUP MEMBER PTAN
F35207Medicare UPIN