Healthcare Provider Details

I. General information

NPI: 1366467193
Provider Name (Legal Business Name): CYNTHIA MONTGOMERY CUTTING NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 W 34TH ST ATTN. ST. PAUL'S CENTER - LOWER LEVEL
NEW YORK NY
10001-2321
US

IV. Provider business mailing address

PO BOX 13
WILLIAMSVILLE VT
05362-0013
US

V. Phone/Fax

Practice location:
  • Phone: 212-695-3444
  • Fax: 212-695-0242
Mailing address:
  • Phone: 802-348-6372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF400886-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: