Provider Demographics
NPI:1932297579
Name:GILMOUR, CYNTHIA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:
Last Name:GILMOUR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701-1154
Mailing Address - Country:US
Mailing Address - Phone:845-794-1600
Mailing Address - Fax:845-794-0749
Practice Address - Street 1:518 BROADWAY
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-1154
Practice Address - Country:US
Practice Address - Phone:845-794-1600
Practice Address - Fax:845-794-0749
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF331613363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP12443Medicare UPIN
NY96N091Medicare ID - Type Unspecified