Healthcare Provider Details

I. General information

NPI: 1386631414
Provider Name (Legal Business Name): CYNTHIA POND CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 N MAIN ST
WARSAW NY
14569-1326
US

IV. Provider business mailing address

3920 LAKEVILLE GROVELAND RD
GENESEO NY
14454-9708
US

V. Phone/Fax

Practice location:
  • Phone: 585-786-0150
  • Fax: 585-786-3065
Mailing address:
  • Phone: 585-786-0150
  • Fax: 585-786-3065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: