Provider Demographics
NPI:1982164695
Name:MCKINNEY, CYNTHIA ROSE (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ROSE
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 GOLDENROD DR
Mailing Address - Street 2:
Mailing Address - City:UPPER GWYNEDD
Mailing Address - State:PA
Mailing Address - Zip Code:19446-7606
Mailing Address - Country:US
Mailing Address - Phone:954-614-4473
Mailing Address - Fax:
Practice Address - Street 1:24 HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6099
Practice Address - Country:US
Practice Address - Phone:203-739-6013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program