Healthcare Provider Details

I. General information

NPI: 1659744258
Provider Name (Legal Business Name): CYNTHIA STRONG STRATTON R.N.,C.D.E.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CYNTHIA JANE STRATTON

II. Dates (important events)

Enumeration Date: 11/04/2015
Last Update Date: 11/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

179 N BROAD ST
NORWICH NY
13815-1019
US

IV. Provider business mailing address

7218 AUTUMN RUN TRL
EAST SYRACUSE NY
13057-3008
US

V. Phone/Fax

Practice location:
  • Phone: 607-337-4040
  • Fax: 607-337-4076
Mailing address:
  • Phone: 607-337-4136
  • Fax: 607-337-4076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number441367-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: