Cynthia Larrabee Short – Internal Medicine Physician

Key facts

NPI: 1306974845
Entity type: Individual (NPI type 1)
Primary specialty: Internal Medicine Physician 207R00000X
License: 171757 (NY)
Practice address: 79 North St
Granville, NY 12832-1137
Phone: (518) 642-0612
Fax: (518) 642-0693
NPI assigned: Feb 28, 2007
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Pace Vermont, Inc Adult Day Care Clinic/Center · Colchester, VT · NPI 1770520025

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
171757	NY	MD	Internal Medicine Physician

Practice roles

Organization	Specialty	Status	New patients
Pace Vermont, Inc		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Internal Medicine Physician	207R00000X	171757	NY	Yes

Addresses

Primary practice location

79 North St
Granville, NY 12832-1137

Mailing address

79 North St
Granville, NY 12832-1137
Phone (518) 642-0612

Other practice location 1

786 College Pkwy
PACE Vermont
Colchester, VT 05446-3007
Phone (802) 655-6700

Other providers in Granville, NY

All providers in Granville, NY · Internal Medicine Physician in New York

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.