Provider Demographics
NPI:1003884495
Name:HAUSCHILD, CYNTHIA LEE (OD OPTOMETRIST)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LEE
Last Name:HAUSCHILD
Suffix:
Gender:F
Credentials:OD OPTOMETRIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3825 HIGHLAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:SKANEATELES
Mailing Address - State:NY
Mailing Address - Zip Code:13152
Mailing Address - Country:US
Mailing Address - Phone:315-685-5195
Mailing Address - Fax:
Practice Address - Street 1:297 GRANT AVENUE
Practice Address - Street 2:VISION CENTER INSIDE WALMART
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021
Practice Address - Country:US
Practice Address - Phone:315-255-3525
Practice Address - Fax:315-255-0316
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT0041301152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U32576Medicare UPIN