Individual
CYNTHIA H. ICKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
222 MANOR PL, GREENPORT, NY 11944-1261
(631) 477-2626
(631) 477-2604
Mailing address
222 MANOR PL, GREENPORT, NY 11944-1261
(631) 477-2626
(631) 477-2604
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
205890
NY
Other
Enumeration date
06/22/2006
Last updated
07/08/2007
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