Provider Demographics
NPI:1053608117
Name:CYNTHIA A BERRY
Entity type:Organization
Organization Name:CYNTHIA A BERRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-699-9417
Mailing Address - Street 1:30 MAN MAR DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:PLAINVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02762-2271
Mailing Address - Country:US
Mailing Address - Phone:508-699-2127
Mailing Address - Fax:
Practice Address - Street 1:30 MAN MAR DR
Practice Address - Street 2:SUITE 7
Practice Address - City:PLAINVILLE
Practice Address - State:MA
Practice Address - Zip Code:02762-2271
Practice Address - Country:US
Practice Address - Phone:508-699-2127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-08
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA715622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty