Healthcare Provider Details

I. General information

NPI: 1447461017
Provider Name (Legal Business Name): CINDY L BIRD- KUE RPA C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109-111 DELANCEY ST
NEW YORK NY
10002-6844
US

IV. Provider business mailing address

109-111 DELANCEY ST
NEW YORK NY
10002-3275
US

V. Phone/Fax

Practice location:
  • Phone: 212-614-2840
  • Fax:
Mailing address:
  • Phone: 646-334-0993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number005923
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: