Provider Demographics
NPI:1861490708
Name:PARADISE, CYNTHIA M (NP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:PARADISE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:368 FAUNCE CORNER RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-1257
Mailing Address - Country:US
Mailing Address - Phone:508-998-1994
Mailing Address - Fax:508-998-5781
Practice Address - Street 1:368 FAUNCE CORNER RD
Practice Address - Street 2:SUITE 2
Practice Address - City:DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1257
Practice Address - Country:US
Practice Address - Phone:508-998-1994
Practice Address - Fax:508-998-5781
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA236277363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP00320226OtherRAILROAD MEDICARE
MANP3673Medicare UPIN
MAP00320226OtherRAILROAD MEDICARE