Provider Demographics
NPI:1093950644
Name:NEIBURG, CINDY (PTBS)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:NEIBURG
Suffix:
Gender:F
Credentials:PTBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 E 19TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-4501
Mailing Address - Country:US
Mailing Address - Phone:718-253-6082
Mailing Address - Fax:718-743-8186
Practice Address - Street 1:2072 OCEAN AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-7379
Practice Address - Country:US
Practice Address - Phone:718-616-1450
Practice Address - Fax:718-743-8186
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009741-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist