Provider Demographics
NPI:1174864821
Name:CYRIAC, ELIZABETH (LMT)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:CYRIAC
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9337 215TH ST
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11428-1707
Mailing Address - Country:US
Mailing Address - Phone:917-974-9129
Mailing Address - Fax:
Practice Address - Street 1:414 JERICHO TPKE
Practice Address - Street 2:SUITE 1, 2ND FLOOR
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-4510
Practice Address - Country:US
Practice Address - Phone:917-974-9129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025302225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist