Provider Demographics
NPI:1396158713
Name:NEKOS, CYNTHIA DAWN
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:DAWN
Last Name:NEKOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477-1311
Mailing Address - Country:US
Mailing Address - Phone:845-247-0010
Mailing Address - Fax:
Practice Address - Street 1:31 MARKET ST
Practice Address - Street 2:
Practice Address - City:SAUGERTIES
Practice Address - State:NY
Practice Address - Zip Code:12477-1311
Practice Address - Country:US
Practice Address - Phone:845-247-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046426183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist