Healthcare Provider Details

I. General information

NPI: 1265167258
Provider Name (Legal Business Name): ANTONIO VINCENT CINTRON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2022
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 ROBERT RD
CORNWALL NY
12518-1609
US

IV. Provider business mailing address

10 ROBERT RD
CORNWALL NY
12518-1609
US

V. Phone/Fax

Practice location:
  • Phone: 845-542-8782
  • Fax:
Mailing address:
  • Phone: 845-542-8782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: