Provider Demographics
NPI:1871555714
Name:MAZER, CYNTHIA (MD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:MAZER
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 1:200 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4235
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 OLD COUNTRY RD
Practice Address - Street 2:SUITE 125
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4235
Practice Address - Country:US
Practice Address - Phone:516-663-4528
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY191087-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY191087OtherHIP
NY0500523OtherUNITED HEALTH FAM. H
NY1303197OtherFIRST HEALTH
NY305514OtherAETNA USHC (PPO)
NY580465OtherAETNA USHC(HMO,FAM.PLAN)
NY01605141Medicaid
NY1118983Medicaid
NY3000614OtherGHI
NY108990OtherUS FAMILY HEALTH PLAN
NY736911OtherBLUE CHOICE
NYP406417OtherOXFORD
NYOC9280OtherHEALTH NET (PHS)
NY1409941OtherUNITED HEALTHCARE
NY3550508005OtherCIGNA
NY64475OtherVYTRA
NY64475OtherVYTRA
NYBM4646862OtherDEA
NY108990OtherUS FAMILY HEALTH PLAN