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General NPI Number Information
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NPI Number | 1881650745
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Entity Type | Individual
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Provider Name | CYNTHIA L. HISSONG RPH
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Gender | Female
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Dates
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Enumeration Date | 04/21/2006
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Last Update Date | 03/24/2012
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Provider Practice Location Address
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Address Line | 251 E ANTIETAM ST
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City | HAGERSTOWN
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State | MD
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Zip | 21740-5724
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Country | US
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Telephone | 301-790-8643
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Fax | 301-790-8651
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Provider Business Mailing Address
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Address Line | 251 E ANTIETAM ST
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City | HAGERSTOWN
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State | MD
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Zip | 21740-5724
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 14745
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP043326L
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License Number State | PA
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