Provider Demographics
NPI:1821776774
Name:IWUNZE, CYNTHIA C (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:C
Last Name:IWUNZE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 THOMAS SALAMONE CIR
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-3955
Mailing Address - Country:US
Mailing Address - Phone:617-895-9553
Mailing Address - Fax:
Practice Address - Street 1:100 HANCOCK ST FL 9
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171-1745
Practice Address - Country:US
Practice Address - Phone:508-927-1176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2304852363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health