Provider Demographics
NPI:1124339817
Name:CYR, JOHN F (PA-C)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:CYR
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 LONGWOOD AVE
Mailing Address - Street 2:FIRST OFFICE FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5726
Mailing Address - Country:US
Mailing Address - Phone:617-278-0145
Mailing Address - Fax:
Practice Address - Street 1:350 LONGWOOD AVE
Practice Address - Street 2:FIRST OFFICE FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5726
Practice Address - Country:US
Practice Address - Phone:617-278-0145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA3987363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant