Cynthia H. Ickes, M.d., P.c.

NPI #1568765204 in Greenport, New York

Provider Information

NPI Number: 1568765204
Entity Type: Organization
Organization Name: Cynthia H. Ickes, M.d., P.c.
Primary Specialty: Internal Medicine
Enumeration Date: Dec 20, 2010
Last Updated: Dec 20, 2010

Practice Location

Address: 222 MANOR PL
City: Greenport
State: New York
ZIP Code: 11944-1261
Phone: (631) 477-2626

Authorized Official

Name: MS. CYNTHIA H. ICKES, M.D.
Title: PRESIDENT
Phone: (631) 477-2626

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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