Healthcare Provider Details

I. General information

NPI: 1649370909
Provider Name (Legal Business Name): CYNTHIA DUNHAM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 EWING STREET C-15
PRINCETON NJ
08540
US

IV. Provider business mailing address

601 EWING STREET C-15
PRINCETON NJ
08540
US

V. Phone/Fax

Practice location:
  • Phone: 609-921-2300
  • Fax: 609-921-9137
Mailing address:
  • Phone: 609-921-2300
  • Fax: 609-921-9137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMA58734
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: