Provider Demographics
NPI:1871764845
Name:CYNTHIA LIGENZA MD PC
Entity type:Organization
Organization Name:CYNTHIA LIGENZA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIGENZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-265-1006
Mailing Address - Street 1:1756 ROUTE 9D
Mailing Address - Street 2:CAROLYN LAHEY PAVILION
Mailing Address - City:COLD SPRING
Mailing Address - State:NY
Mailing Address - Zip Code:10516-2619
Mailing Address - Country:US
Mailing Address - Phone:845-265-1006
Mailing Address - Fax:845-265-4548
Practice Address - Street 1:1756 ROUTE 9D
Practice Address - Street 2:CAROLYN LAHEY PAVILION
Practice Address - City:COLD SPRING
Practice Address - State:NY
Practice Address - Zip Code:10516-2619
Practice Address - Country:US
Practice Address - Phone:845-265-1006
Practice Address - Fax:845-265-4548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY147833-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01177100Medicaid