Healthcare Provider Details

I. General information

NPI: 1962832154
Provider Name (Legal Business Name): CYNTHIA POPOFF HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2013
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1459 N DYSART RD
AVONDALE AZ
85323
US

IV. Provider business mailing address

13339 W MARLETTE CT
LITCHFIELD PARK AZ
85340
US

V. Phone/Fax

Practice location:
  • Phone: 623-925-2299
  • Fax: 870-424-6950
Mailing address:
  • Phone: 870-405-4573
  • Fax: 870-424-6950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHADR9509
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: