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NPI Code Detail

MEDICARE: CINDY SUTANTIO CNP

MEDICARE: CINDY SUTANTIO CNP
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
1363LA2200XAdult Health Nurse Practitioner15084OH
2363LA2200XAdult Health Nurse PractitionerF308724NY

General Provider Information

NPI Number : 1811319551
Entity Type Code : Individual
Provider Name (Legal Business Name) : CINDY SUTANTIO CNP
Provider Business Mailing Address
First Line : 7 KNOX RD
Second Line :
City : EASTCHESTER
State : NY
Zip : 10709-1420
Country : US
Telephone Number : 614-804-7820
Fax Number :
Provider Business Practice Location Address
First Line : 211 E 51ST ST
Second Line :
City : NEW YORK
State : NY
Zip : 10022-6526
Country : US
Telephone Number : 212-398-1709
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2014
Last Update Date : 10/23/2018

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Directions to “ CINDY SUTANTIO CNP” Practice Location

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