Provider Demographics
NPI:1588777148
Name:PYLE, CYNTHIA GENOVA (LCSW)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:GENOVA
Last Name:PYLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:GENOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3367 MAPLEWOOD DR N
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-3420
Mailing Address - Country:US
Mailing Address - Phone:516-319-4263
Mailing Address - Fax:
Practice Address - Street 1:1400 WANTAGH AVE STE 201
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-2210
Practice Address - Country:US
Practice Address - Phone:516-319-4263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR049923-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical