Provider Demographics
NPI:1518930544
Name:FRASER, CYNTHIA H (MD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:H
Last Name:FRASER
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:PO BOX 2337
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13220-2337
Mailing Address - Country:US
Mailing Address - Phone:315-701-5607
Mailing Address - Fax:315-701-5608
Practice Address - Street 1:7785 N STATE ST
Practice Address - Street 2:SUITE 210
Practice Address - City:LOWVILLE
Practice Address - State:NY
Practice Address - Zip Code:13367-1229
Practice Address - Country:US
Practice Address - Phone:315-348-8407
Practice Address - Fax:315-376-5129
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228497207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP010228497OtherBLUE SHIELD
NYP010228497OtherBLUE CHOICE
NYMDH508OtherPREFERRED CARE
NY02462733Medicaid
NY02462733Medicaid
NYMDH508OtherPREFERRED CARE
NYDD5718Medicare ID - Type Unspecified