Provider Demographics
NPI:1720614282
Name:BRISLEY, CYNTHIA ELLEN (BA)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ELLEN
Last Name:BRISLEY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14141-1129
Mailing Address - Country:US
Mailing Address - Phone:716-337-3706
Mailing Address - Fax:
Practice Address - Street 1:98 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:14141-1508
Practice Address - Country:US
Practice Address - Phone:716-337-3706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist