CYNTHIA J PROVOW (NPI# 1922288844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1922288844 |
Entity Type | Individual |
Full Name | CYNTHIA J PROVOW |
Credential | MD |
Practice Address |
80 State Highway 310 Ste 1 Canton NY 13617-1436 |
Mailing Address |
80 State Highway 310 Canton NY 13617-1436 |
Practice Telephone | 3153862189 |
Practice Fax Number | 3153862435 |
Mailing Telephone | 3153862189 |
Mailing Fax Number | 3153862435 |
Enumeration Date | 2007-11-08 |
Last Update Date | 2018-03-17 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207V00000X | Obstetrics & Gynecology | 259347 | NY | Allopathic & Osteopathic Physicians |
N | 207V00000X | Obstetrics & Gynecology | 234215 | MA | Allopathic & Osteopathic Physicians |
Y | 208D00000X | General Practice | 259347 | NY | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
HARVARD | AA103237 | 01 | |
HNE | 42392 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
22 Center St, Massena, NY 136621437 | 3157640265 | 3157645941 |
Street Address |
80 STATE HIGHWAY 310 STE 1 |
City | CANTON |
State | NY |
Zip Code | 13617-1436 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043304645 | Patricia Pielnik | Psychiatry & Neurology | 80 State Highway 310 Ste 1, Canton, NY 13617-1436 | 2006-10-03 |
1659985158 | Tracy Hart | Peer Specialist | 80 State Highway 310 Ste 1, Canton, NY 13617-1493 | 2020-09-02 |
1689232860 | Randyl Shane Chase | Counselor | 80 State Highway 310 Ste 1, Canton, NY 13617-1493 | 2019-06-03 |
1891285631 | Brianna Kessler | Student in an Organized Health Care Education/Training Program | 80 State Highway 310 Ste 1, Canton, NY 13617-1493 | 2018-05-17 |
1720588742 | Lakshmi Nair | Registered Nurse | 80 State Highway 310 Ste 1, Canton, NY 13617-1436 | 2018-02-16 |
1669879060 | Kaylie E. Deshane | Counselor | 80 State Highway 310 Ste 1, Canton, NY 13617-1436 | 2014-12-01 |
1447667878 | Kristina Beth Kelly-snow | Counselor | 80 State Highway 310 Ste 1, Canton, NY 13617-1436 | 2014-07-17 |
1376827196 | Gidget Q.v. Rafus-rousell | Counselor | 80 State Highway 310 Ste 1, St. Lawrence County Community, Canton, NY 13617-1436 | 2011-09-29 |
1376664425 | Sheri L Page | Registered Nurse | 80 State Highway 310 Ste 1, Canton, NY 13617-1436 | 2007-04-03 |
1346371705 | Antoine Gabriel | Psychiatry & Neurology | 80 State Highway 310 Ste 1, Canton, NY 13617-1436 | 2007-03-08 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700428802 | Meagan Elizabeth Hogan | Physician Assistant | 6119 Us Highway Route 11, Canton, NY 13617 | 2019-10-10 |
1982251740 | Wilma J. Blackmer | Technician | 1756 Cr 14, Canton, NY 13617 | 2019-08-26 |
1326525270 | Kylie Broughal | Physician Assistant | 6119 St Hwy Rt 11, St Lawrence Medical Office Complex, Canton, NY 13617 | 2018-07-24 |
1891299608 | Sheena Teresa Smith | Counselor | 310 State Highway 310, Suite 1, Canton, NY 13617 | 2018-03-19 |
1972024594 | Patrick James Sullivan | Physician Assistant | 6619 State Highway Route 11, Canton, NY 13617 | 2017-07-05 |
1225482763 | Howard Orthotics and Prosthetics, LLC | Prosthetic/Orthotic Supplier | 6128 Us Highway11, Canton, NY 13617 | 2016-04-21 |
1831534452 | Chin Hung Ho | Dermatology | 6119 State Highway Rt 11, Cph Dermotology, Canton, NY 13617 | 2013-05-09 |
1194061663 | Sarah Prairie | Counselor | 80 State Hwy 310, Suite 1, Canton, NY 13617 | 2013-01-02 |
1679859094 | Nathan Ellis | Occupational Therapist | 139 Outer State St. Rd, Canton, NY 13617 | 2011-10-31 |
1407139017 | Julianne Rutley | Occupational Therapist | 139 Outer State Street Rd, Canton, NY 13617 | 2011-09-21 |
Find all providers in zip 13617 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
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1760089585 | Tanya Millicent Kyler | General Practice | 512 Shorb Ave Nw Apt 3, Canton, OH 44703-2580 | 2020-10-05 |
1578835690 | Michael David Cuomo | General Practice | 1026 Sugar Pike Way, Canton, GA 30115-5423 | 2012-02-05 |
1154619237 | Abraham Home Visiting Physicians, P.C. | General Practice | 48558 Woodson Way, Canton, MI 48187-6675 | 2011-07-11 |
1528210911 | Sandra R. Beichler, D.o., Inc. | General Practice | 6310 Middlebranch Ave Ne, Canton, OH 44721-3555 | 2008-10-16 |
1083812457 | Piyush J Shah | General Practice | 7283 Kingsbridge Court, Canton, MI 48187-2407 | 2007-07-06 |
1780893602 | William Truly | General Practice | East Peace St, Canton, MS 39046-1069 | 2007-05-21 |
1447307632 | Kellie Suzanne Johnson | General Practice | 2221 9th St Sw, Canton, OH 44706-1464 | 2007-01-03 |
1346269073 | Chin-shee Chong | General Practice | 442 Washington St, Canton, MA 02021-3630 | 2006-07-19 |
1396703260 | John Francis Mccarthy | General Practice | 2 Devonshire Dr, Canton, MA 02021-1570 | 2006-05-02 |
1053825448 | Apex Physical Medicine, Inc | General Practice | 4883 Dressler Rd Nw Ste 100, Canton, OH 44718-3665 | 2017-11-22 |
Find all providers in CANTON |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.