Provider Demographics
NPI:1093766529
Name:FEASTER, CYDNI M (PT)
Entity Type:Individual
Prefix:
First Name:CYDNI
Middle Name:M
Last Name:FEASTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:CYDNI
Other - Middle Name:M
Other - Last Name:FEASTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, CWCE
Mailing Address - Street 1:14 HANSEN CT
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-1713
Mailing Address - Country:US
Mailing Address - Phone:215-459-0727
Mailing Address - Fax:
Practice Address - Street 1:14 HANSEN CT
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-1713
Practice Address - Country:US
Practice Address - Phone:215-459-0727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2016-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT004092225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2740711000OtherPERSONAL CHOICE
PA17918OtherBRAVO/ELDERHEALTH
PA01858967OtherAMERICHOICE
PA045805OtherMEDICARE
PA106167200OtherOWCP
PA001868174OtherHIGHMARK BLUE SHIELD
PA2581987OtherAETNA
PA32298OtherHEALTHPARTNERS
PA2727388000OtherPERSONAL CHOICE
PA001858967OtherDEPARTMENT OF WELFARE