Healthcare Provider Details

I. General information

NPI: 1083668602
Provider Name (Legal Business Name): WILLIAM PATRICK CINTRON PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4709 KIRKWOOD HWY
WILMINGTON DE
19808-5007
US

IV. Provider business mailing address

44 W KYLA MARIE DR
NEWARK DE
19702-5431
US

V. Phone/Fax

Practice location:
  • Phone: 302-998-9880
  • Fax: 302-998-7498
Mailing address:
  • Phone: 302-690-2848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberJ2-0000630
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: