CYNTHIA J PROVOW


Address: 80 State Highway 310 Ste 1, Canton, NY 13617-1436
Phone: 3153862189

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
HARVARD AA103237 01
HNE 42392 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
22 Center St, Massena, NY 136621437 3157640265 3157645941

Office Location

Street Address 80 STATE HIGHWAY 310 STE 1
City CANTON
State NY
Zip Code 13617-1436

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 208D00000X
Grouping Allopathic & Osteopathic Physicians
Classification General Practice

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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
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Competitor

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City CANTON
Zip Code 13617

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Dataset Information

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.

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