Basic Information
| Provider Information | |||||||||
| NPI: | 1174573299 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAYLOR | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4820 W TAFT RD | ||||||||
| Address2: | SUITE 209 | ||||||||
| City: | LIVERPOOL | ||||||||
| State: | NY | ||||||||
| PostalCode: | 130882800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154486215 | ||||||||
| FaxNumber: | 3152344417 | ||||||||
| Practice Location | |||||||||
| Address1: | 4820 W TAFT RD | ||||||||
| Address2: | SUITE 209 | ||||||||
| City: | LIVERPOOL | ||||||||
| State: | NY | ||||||||
| PostalCode: | 130882800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154486215 | ||||||||
| FaxNumber: | 3152344417 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2006 | ||||||||
| LastUpdateDate: | 12/07/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 009661 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.