Provider Demographics
NPI:1609902097
Name:CINTORA, STEPHANIE C (MD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:C
Last Name:CINTORA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 TAFT MILL RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH GRAFTON
Mailing Address - State:MA
Mailing Address - Zip Code:01560-1264
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:27 TAFT MILL RD
Practice Address - Street 2:
Practice Address - City:SOUTH GRAFTON
Practice Address - State:MA
Practice Address - Zip Code:01560-1264
Practice Address - Country:US
Practice Address - Phone:617-359-0067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA245237207L00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110086984AMedicaid
MAS400101437Medicare PIN
MAA3429703Medicare PIN
MAS400101437Medicare PIN