Healthcare Provider Details

I. General information

NPI: 1679667596
Provider Name (Legal Business Name): CYNTHIA ANN DI COLA N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 IRVING STREET NW DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER
WASHINGTON DC
20422
US

IV. Provider business mailing address

5370 THAMES COURT
SYKESVILLE MD
21784
US

V. Phone/Fax

Practice location:
  • Phone: 202-745-8000
  • Fax:
Mailing address:
  • Phone: 410-549-1315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR117917
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: