Individual
MRS. CYNTHIA ANNE VERCILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
8191 SHADBUSH LN, CLAY, NY 13041-8911
(315) 430-6296
Mailing address
8191 SHADBUSH LN, CLAY, NY 13041-8911
(315) 430-6296
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
155037-1
NY
Other
Enumeration date
07/16/2013
Last updated
07/16/2013
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