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NPI Code Detail

MEDICARE: CYNTHIA D HARTLEY PA-C

MEDICARE: CYNTHIA D HARTLEY PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1619112406
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA D HARTLEY PA-C
Provider Business Mailing Address
First Line : 9609 LAKE MIST CT
Second Line :
City : FAIRFAX STATION
State : VA
Zip : 22039-2677
Country : US
Telephone Number : 801-635-6886
Fax Number :
Provider Business Practice Location Address
First Line : 6895 E HAMPDEN AVE
Second Line :
City : DENVER
State : CO
Zip : 80224-3047
Country : US
Telephone Number : 303-861-7878
Fax Number : 303-894-8066
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2008
Last Update Date : 06/27/2023

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Directions to “ CYNTHIA D HARTLEY PA-C” Practice Location

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