Healthcare Provider Details

I. General information

NPI: 1831407907
Provider Name (Legal Business Name): CYNTHIA ANNE DEUTSCH R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2010
Last Update Date: 09/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 TERRACE CIR APT 1A
GREAT NECK NY
11021-4121
US

IV. Provider business mailing address

6 TERRACE CIR APT 1A
GREAT NECK NY
11021-4121
US

V. Phone/Fax

Practice location:
  • Phone: 516-482-4910
  • Fax:
Mailing address:
  • Phone: 516-482-4910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number522354
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: