Provider Demographics
NPI:1942566542
Name:RICHARDSON, CYNTHIA (OCCUPATIONAL THERAPY)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2545 GUNTHER AVE.
Mailing Address - Street 2:M.S. #144
Mailing Address - City:BRONX, NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10469-0000
Mailing Address - Country:US
Mailing Address - Phone:718-379-7400
Mailing Address - Fax:718-320-7135
Practice Address - Street 1:2545 GUNTHER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-6105
Practice Address - Country:US
Practice Address - Phone:718-379-7400
Practice Address - Fax:718-320-7135
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001788-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist