Provider Demographics
NPI:1104878214
Name:SETOODEH, CYNTHIA ELIZABETH (MSN, APN-C)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ELIZABETH
Last Name:SETOODEH
Suffix:
Gender:F
Credentials:MSN, APN-C
Other - Prefix:
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Mailing Address - Street 1:44 GODWIN AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1969
Mailing Address - Country:US
Mailing Address - Phone:201-444-5992
Mailing Address - Fax:201-444-9984
Practice Address - Street 1:44 GODWIN AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1969
Practice Address - Country:US
Practice Address - Phone:201-444-5992
Practice Address - Fax:201-444-9984
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2014-06-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00057600363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ100989WC0Medicare PIN