Provider Demographics
NPI:1770902504
Name:PRICE, CYNTHIA LANE (RN)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LANE
Last Name:PRICE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 FREEVILLE RD.
Mailing Address - Street 2:
Mailing Address - City:DRYDEN
Mailing Address - State:NY
Mailing Address - Zip Code:13053
Mailing Address - Country:US
Mailing Address - Phone:607-844-8694
Mailing Address - Fax:607-844-9121
Practice Address - Street 1:118 FREEVILLE RD.
Practice Address - Street 2:
Practice Address - City:DRYDEN
Practice Address - State:NY
Practice Address - Zip Code:13053
Practice Address - Country:US
Practice Address - Phone:607-844-8694
Practice Address - Fax:607-844-9121
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY468987-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool