Provider Demographics
NPI:1457610370
Name:QUELL, CYNTHIA KAREN (LAC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:KAREN
Last Name:QUELL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 HOBART AVE
Mailing Address - Street 2:
Mailing Address - City:PORT CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10573-2710
Mailing Address - Country:US
Mailing Address - Phone:914-420-2767
Mailing Address - Fax:
Practice Address - Street 1:46 HOBART AVE
Practice Address - Street 2:
Practice Address - City:PORT CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10573-2710
Practice Address - Country:US
Practice Address - Phone:914-420-2767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-12
Last Update Date:2012-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004811171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist