Provider Demographics
NPI:1295085702
Name:VUITTONET, CYNTHIA (MD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:VUITTONET
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 1:275 HOBART ST
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-3396
Mailing Address - Country:US
Mailing Address - Phone:732-376-9333
Mailing Address - Fax:844-584-1477
Practice Address - Street 1:275 HOBART ST
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-3396
Practice Address - Country:US
Practice Address - Phone:732-376-9333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP02680207R00000X
MA262341207R00000X
NJ25MA10264700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0621421Medicaid