Healthcare Provider Details

I. General information

NPI: 1477804920
Provider Name (Legal Business Name): CYNTHIA JO SLOMOWITZ M.S., L.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2012
Last Update Date: 09/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 MAPLE LN
GLEN MILLS PA
19342-1287
US

IV. Provider business mailing address

33 MAPLE LN
GLEN MILLS PA
19342-1287
US

V. Phone/Fax

Practice location:
  • Phone: 610-659-1409
  • Fax:
Mailing address:
  • Phone: 610-659-1409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT05675L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: