Provider Demographics
NPI:1285804567
Name:VELLA, CYNTHIA A (NP)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:VELLA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:WEST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02379-1506
Mailing Address - Country:US
Mailing Address - Phone:508-588-6200
Mailing Address - Fax:508-588-6211
Practice Address - Street 1:22 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:WEST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02379-1506
Practice Address - Country:US
Practice Address - Phone:508-588-6200
Practice Address - Fax:508-588-6211
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA169978363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health