Provider Demographics
NPI:1902895980
Name:CIESZKO, CYNTHIA A (OD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:A
Last Name:CIESZKO
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:4633 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-5742
Mailing Address - Country:US
Mailing Address - Phone:770-457-3618
Mailing Address - Fax:770-698-8821
Practice Address - Street 1:4400 ASHFORD DUNWOODY RD NE
Practice Address - Street 2:1280 PERIMETER MALL
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30346-1518
Practice Address - Country:US
Practice Address - Phone:770-396-8070
Practice Address - Fax:770-698-8821
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAGA1076T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist