Individual
MS. GWENDOLYN CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-2500
Mailing address
51 SADDLE RIDGE RD, OSSINING, NY 10562-3004
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
011459
NY
363AS0400X
Surgical Physician Assistant
011459
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00246075
—
NY
Enumeration date
10/26/2006
Last updated
12/19/2011
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