Healthcare Provider Details

I. General information

NPI: 1255468500
Provider Name (Legal Business Name): CYNTHIA A TREIBER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 02/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5645 MAIN ST
FLUSHING NY
11355-5045
US

IV. Provider business mailing address

PO BOX 30548
NEW YORK NY
10087-0548
US

V. Phone/Fax

Practice location:
  • Phone: 718-670-1435
  • Fax:
Mailing address:
  • Phone: 866-570-0077
  • Fax: 248-479-0652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number150348-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: