Provider Demographics
NPI:1770692790
Name:WECHSLER, CINDY (APRN)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:WECHSLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:WECHSLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:240 INDIAN RIVER RD
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-3649
Mailing Address - Country:US
Mailing Address - Phone:203-795-6025
Mailing Address - Fax:203-799-1554
Practice Address - Street 1:240 INDIAN RIVER RD
Practice Address - Street 2:SUITE B-1
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-3649
Practice Address - Country:US
Practice Address - Phone:203-795-6025
Practice Address - Fax:203-799-1554
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000264363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004241923Medicaid