Provider Demographics
NPI:1295852457
Name:TAYLOR, CYNTHIA (REGISTERED NURSE)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:MRS
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICENSED PRACTICAL N
Mailing Address - Street 1:2500 MCCLELLAN BLVD
Mailing Address - Street 2:
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-4613
Mailing Address - Country:US
Mailing Address - Phone:856-745-0572
Mailing Address - Fax:
Practice Address - Street 1:2500 MCCLELLAN AVENUE
Practice Address - Street 2:SUITE 300
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08109
Practice Address - Country:US
Practice Address - Phone:856-361-1100
Practice Address - Fax:856-488-1450
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP05035800164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse