MEDICARE: DR. CINDY LEE ST. ONGE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	036295	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770675670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CINDY LEE ST. ONGE M.D.

Provider Business Mailing Address
First Line	:	30 W AVON RD STE D
Second Line	:
City	:	AVON
State	:	CT
Zip	:	06001-3678
Country	:	US
Telephone Number	:	860-678-0484
Fax Number	:	860-678-1454

Provider Business Practice Location Address
First Line	:	30 W AVON RD STE D
Second Line	:
City	:	AVON
State	:	CT
Zip	:	06001-3678
Country	:	US
Telephone Number	:	860-678-0484
Fax Number	:	860-678-1454

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	08/12/2025

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