Individual
CYNTHIA BOOTH LORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2 LEE RD, LISBON, CT 06351
(860) 376-4451
(860) 376-5977
Mailing address
2 LEE RD, LISBON, CT 06351
(860) 376-4451
(860) 376-5977
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000055
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290000055CT01
BCBS
—
01
—
2V3813
HEALTHNET
—
Enumeration date
06/01/2005
Last updated
11/19/2009
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