Provider Demographics
NPI:1992242341
Name:CAMILO, CYNTHALI
Entity type:Individual
Prefix:MS
First Name:CYNTHALI
Middle Name:
Last Name:CAMILO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 COLONY LN
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2218
Mailing Address - Country:US
Mailing Address - Phone:516-621-1281
Mailing Address - Fax:516-334-8954
Practice Address - Street 1:59 COLONY LN
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2218
Practice Address - Country:US
Practice Address - Phone:516-621-1281
Practice Address - Fax:516-334-8954
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator