Provider Demographics
NPI:1952738775
Name:BREDBERG, CINDY
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:BREDBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 SANDY HILL RD
Mailing Address - Street 2:THE COTTAGE
Mailing Address - City:OYSTER BAY
Mailing Address - State:NY
Mailing Address - Zip Code:11771-3110
Mailing Address - Country:US
Mailing Address - Phone:516-551-8330
Mailing Address - Fax:
Practice Address - Street 1:53 SANDY HILL RD
Practice Address - Street 2:THE COTTAGE
Practice Address - City:OYSTER BAY
Practice Address - State:NY
Practice Address - Zip Code:11771-3110
Practice Address - Country:US
Practice Address - Phone:516-551-8330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-11
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist