Individual
MRS. CYNTHIA E CAVANAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2968 GULF RD, MANLIUS, NY 13104
(315) 655-2597
Mailing address
2968 GULF RD, MANLIUS, NY 13104
(315) 655-2597
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
296622 1
NY
163WP0200X
Pediatric Registered Nurse
296622 1
NY
163WP0808X
Psychiatric/Mental Health Registered Nurse
296622 1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02640393
—
NY
Enumeration date
09/24/2007
Last updated
09/24/2007
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