=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316001852
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CYPRESS MEDICAL PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/20/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1684 WOODBINE ST
-----------------------------------------------------
City | RIDGEWOOD
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11385
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-497-8117
-----------------------------------------------------
Fax | 718-497-3208
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16-84 WOODBINE ST
-----------------------------------------------------
City | RIDGEWOOD
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11385
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-497-8117
-----------------------------------------------------
Fax | 718-497-3208
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT MD
-----------------------------------------------------
Name | DR. SMARANDA COCIOBA
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 718-497-8117
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number | 164309
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number | 164309
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------