Provider Demographics
NPI:1871668186
Name:CONRAD, CYNTHIA D (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:D
Last Name:CONRAD
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 1:9 WINGATE RD
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-3726
Mailing Address - Country:US
Mailing Address - Phone:203-499-7096
Mailing Address - Fax:203-453-4225
Practice Address - Street 1:9 WINGATE RD
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-3726
Practice Address - Country:US
Practice Address - Phone:203-499-7096
Practice Address - Fax:203-453-4225
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0222502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
B39640Medicare UPIN