Healthcare Provider Details

I. General information

NPI: 1578684619
Provider Name (Legal Business Name): CYNTHIA L PLOUTZ FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 FOX CARE DR
ONEONTA NY
13820-2086
US

IV. Provider business mailing address

1 FOX CARE DR
ONEONTA NY
13820-2086
US

V. Phone/Fax

Practice location:
  • Phone: 607-431-5366
  • Fax:
Mailing address:
  • Phone: 607-431-5366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF3308011
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: