Healthcare Provider Details

I. General information

NPI: 1487282091
Provider Name (Legal Business Name): CINTHIA PI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12692 LAMPLIGHTER SQUARE SHPG CTR
SAINT LOUIS MO
63128-2746
US

IV. Provider business mailing address

12990 MANCHESTER RD STE 201
SAINT LOUIS MO
63131-1860
US

V. Phone/Fax

Practice location:
  • Phone: 314-432-5478
  • Fax:
Mailing address:
  • Phone: 314-909-0633
  • Fax: 314-909-0391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number2024036363
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: