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CYNTHIA J PROVOW MD
NPI 1922288844
General Practice in Canton, NY

Active since November 08, 2007PECOS Enrolled
80 STATE HIGHWAY 310 STE 1, CANTON, NY 13617(315) 386-2189(315) 386-2435 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 17, 2018, Dec 13, 2017 (2 updates tracked since 2017).

About Cynthia J Provow Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CYNTHIA J PROVOW MD (NPI 1922288844) is an individual general practice provider in Canton, New York, licensed in New York (259347) and active in the NPI registry since November 2007. She is enrolled in Medicare PECOS and maintains a secondary practice location in Massena.

NPPES Registry Identity

NPI1922288844
Entity TypeIndividualFemale
Primary Taxonomy208D00000X
Provider Legal NameCYNTHIA J PROVOWCredential: MD
Location Address80 STATE HIGHWAY 310 STE 1Canton, NY 13617-1436
Mailing Address80 State Highway 310Canton, NY 13617-1436 · (315) 386-2189 · Fax (315) 386-2435
Phone(315) 386-2189
Fax(315) 386-2435
Sole ProprietorNo
Enumeration DateNovember 8, 2007
Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration
✔ NPI 1922288844 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in NY · 259347
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedObstetrics & GynecologyTaxonomy 207V00000X · License 234215 (MA), 259347 (NY)
80 STATE HIGHWAY 310 STE 1, Canton, NY 13617
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Secondary Practice Location 1

Location 122 Center StMassena, NY 13662-1437 · Phone (315) 764-0265 · Fax (315) 764-5941

Other Identifiers 2

Other42392Hne
OtherAA103237Harvard

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Cynthia J Provow Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ANTOINE GABRIEL MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
80 STATE HIGHWAY 310 STE 1
CANTON, NY 13617
St. Lawrence County (315) 386-2167
KRISTINA BETH KELLY-SNOW MS IN MENTAL HEALTH
Counselor (Mental Health)
80 STATE HIGHWAY 310 STE 1
CANTON, NY 13617
St. Lawrence County (315) 386-2167
PATRICIA PIELNIK MD
Psychiatry & Neurology (Psychiatry)
80 STATE HIGHWAY 310 STE 1
CANTON, NY 13617
St. Lawrence County (315) 386-2167
MS. GIDGET Q.V. RAFUS-ROUSELL CASAC II
Counselor (Mental Health)
80 STATE HIGHWAY 310 STE 1, ST. LAWRENCE COUNTY COMMUNITY
CANTON, NY 13617
St. Lawrence County (315) 386-2167
MS. KAYLIE E. DESHANE CASAC
Counselor (Addiction (Substance Use Disorder))
80 STATE HIGHWAY 310 STE 1
CANTON, NY 13617
St. Lawrence County (315) 386-2189
RANDYL SHANE CHASE
Counselor (Addiction (Substance Use Disorder))
80 STATE HIGHWAY 310 STE 1
CANTON, NY 13617
St. Lawrence County (315) 386-2189
HEATHER DEDRICK RN
Registered Nurse (Addiction (Substance Use Disorder))
80 STATE HIGHWAY 310 STE 1
CANTON, NY 13617
St. Lawrence County (315) 386-2189
ST LAWRENCE COUNTY
Community/Behavioral Health
80 STATE HIGHWAY 310 STE 1
CANTON, NY 13617
St. Lawrence County (315) 386-2167

Frequently Asked Questions

What is Cynthia Provow's NPI number?

The NPI number assigned to this healthcare provider is 1922288844, enumerated as an "individual" on November 08, 2007.

Where is the provider located?

The provider is located at 80 STATE HIGHWAY 310 STE 1 CANTON, NY 13617 and the phone number is (315) 386-2189.

What is the provider's specialty?

General Practice with taxonomy code 208D00000X.

What insurance does Cynthia Provow accept?

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.