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1891739306 NPI number — CYNTHIA LYNN DESMARAIS PT

NPI Number: 1891739306
Health Care Provider/Practitioner: CYNTHIA LYNN DESMARAIS PT

Information about “1891739306” NPI (CYNTHIA LYNN DESMARAIS PT) exists in 1891739306 in HTML format HTML  |  1891739306 in plain Text format TXT  |  1891739306 in PDF (Portable Document Format) PDF  |  1891739306 in an XML format XML  formats.

NPI Number : 1891739306 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1891739306",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DESMARAIS",
    "FirstName": "CYNTHIA",
    "MiddleName": "LYNN",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "PT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "FORBES",
    "OtherFirstName": "CYNTHIA",
    "OtherMiddleName": "LYNN",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": "PT",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "2408 WHITNEY AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HAMDEN",
    "MailingAddressStateName": "CT",
    "MailingAddressPostalCode": "06518-3209",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "203-626-0160",
    "MailingAddressFaxNumber": "203-294-6734",
    "FirstLinePracticeLocationAddress": "2416 WHITNEY AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HAMDEN",
    "PracticeLocationAddressStateName": "CT",
    "PracticeLocationAddressPostalCode": "06518-3248",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "203-407-3590",
    "PracticeLocationAddressFaxNumber": "203-466-8527",
    "EnumerationDate": "06/15/2006",
    "LastUpdateDate": "03/07/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "007651",
        "LicenseNumberStateCode": "CT",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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