Basic Information
| Provider Information | |||||||||
| NPI: | 1922158492 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CYRIL | ||||||||
| FirstName: | CICILY | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 TRANTOR PL | ||||||||
| Address2: | APT # 1 D | ||||||||
| City: | STATEN ISLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 103021965 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184471193 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 506 MALCOLM X BLVD | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100371802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129391761 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 183500000X | 041869-1 | NY | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.