Cynthia Enriquez Desepeda, MD EARLY CHILDHOOD

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

9777 Queens Blvd
Rego Park, NY 11374-3335

Phone

(718) 830-9274

Fax

(718) 830-0761

NPI assigned

May 28, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369699200000",
    "number": "1295172500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5764 MAZEAU ST",
            "city": "MASPETH",
            "state": "NY",
            "postal_code": "113781927",
            "telephone_number": "347-224-5516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9777 QUEENS BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743335",
            "telephone_number": "718-830-9274",
            "fax_number": "718-830-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESEPEDA",
        "first_name": "CYNTHIA",
        "middle_name": "ENRIQUEZ",
        "name_prefix": "Mrs.",
        "credential": "MD EARLY CHILDHOOD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-28",
        "last_updated": "2013-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.