Healthcare Provider Details

I. General information

NPI: 1811907504
Provider Name (Legal Business Name): CYNTHIA ANGEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 06/29/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 LATTIMORE RD SUITE 258
ROCHESTER NY
14620-4159
US

IV. Provider business mailing address

125 LATTIMORE RD SUITE 258
ROCHESTER NY
14620-4159
US

V. Phone/Fax

Practice location:
  • Phone: 585-442-8077
  • Fax: 585-442-8039
Mailing address:
  • Phone: 585-442-8077
  • Fax: 585-442-8039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number151104
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: