Provider Demographics
NPI:1740367473
Name:ZARA, CYNTHIA (OD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:ZARA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 COMMERCE AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-4454
Mailing Address - Country:US
Mailing Address - Phone:631-727-0880
Mailing Address - Fax:
Practice Address - Street 1:1115 5TH AVE
Practice Address - Street 2:C/O B. DAVID GORMAN, MD
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-0100
Practice Address - Country:US
Practice Address - Phone:212-517-4500
Practice Address - Fax:212-517-4116
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006678-01152WC0802X
NYTRO006678152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYTUV006678OtherNYS OPTOMETRIC LICENSE #
NYTUV006678OtherNYS OPTOMETRIC LICENSE #
NYC304G1Medicare ID - Type UnspecifiedMEDICARE ID NUMBER