Provider Demographics
NPI:1013351568
Name:HAZELTON, CYNTHIA N
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:N
Last Name:HAZELTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 HORTON HWY
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-1420
Mailing Address - Country:US
Mailing Address - Phone:516-248-5609
Mailing Address - Fax:
Practice Address - Street 1:430 HORTON HWY
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-1420
Practice Address - Country:US
Practice Address - Phone:516-248-5609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-25
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist