Provider Demographics
NPI:1699776799
Name:JONES, CYNTHIA B (MD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:B
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 317
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NY
Mailing Address - Zip Code:13346-0317
Mailing Address - Country:US
Mailing Address - Phone:315-824-6652
Mailing Address - Fax:315-824-6544
Practice Address - Street 1:3045 JOHN TRUSH BLVD
Practice Address - Street 2:ROUTE 20 EAST
Practice Address - City:CAZENOVIA
Practice Address - State:NY
Practice Address - Zip Code:13035-9541
Practice Address - Country:US
Practice Address - Phone:315-655-8696
Practice Address - Fax:315-655-4408
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY188395207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G38426Medicare UPIN