Doctor Name: | MRS. CYNTHIA ELIZABETH KODAS |
NPI Number: | 1487908083 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | RN2266954 |
Business Practice Address: | 67d Main St Medway, MA - 020531831 |
Business Phone Number: | 8663892727 |
Business Fax Number: | |
Mailing Address: | 135 Kimball Rd, CARLISLE |
State: | MA |
Postal Code: | 017411036 |
Phone Number: | 9783694021 |
Fax Number: | |
NPI Enumeration Date: | 11/04/2012 |
NPI Last Update Date: | 11/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN2266954 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |