Provider Demographics
NPI:1962432427
Name:BARRY, CYNTHIA DARLENE (DO)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:DARLENE
Last Name:BARRY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:725 W ELLIOT RD
Mailing Address - Street 2:BLDG. 3; SUITE 105
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-5301
Mailing Address - Country:US
Mailing Address - Phone:480-963-6144
Mailing Address - Fax:480-899-1404
Practice Address - Street 1:725 W ELLIOT RD
Practice Address - Street 2:BLDG. 3; SUITE 105
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-5301
Practice Address - Country:US
Practice Address - Phone:480-963-6144
Practice Address - Fax:480-899-1404
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2752207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ25095Medicare ID - Type Unspecified
AZE73649Medicare UPIN