Individual
DR. CYNTHIA A MALVITZ-OVERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D., F.A.A.O.
Contact information
Practice address
1515 6TH ST, GREEN BAY, WI 54304-2272
(920) 499-2147
(920) 499-0574
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2511-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2511-035
STATE LICENSE #
WI
Enumeration date
01/30/2007
Last updated
03/07/2023
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