Provider Demographics
NPI:1205812575
Name:BENZINGER GLEIM, CECILIA MARGARET (PT, DPT, OCS)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:MARGARET
Last Name:BENZINGER GLEIM
Suffix:
Gender:F
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:CECILIA
Other - Middle Name:MARGARET
Other - Last Name:GLEIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, OCS
Mailing Address - Street 1:PO BOX 69030
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-9030
Mailing Address - Country:US
Mailing Address - Phone:757-873-2302
Mailing Address - Fax:757-873-2306
Practice Address - Street 1:2004 SANDBRIDGE RD STE 102
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-4084
Practice Address - Country:US
Practice Address - Phone:757-301-6316
Practice Address - Fax:757-301-6419
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT-05552225100000X
VA2305207158225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1205812575Medicaid
VAC05954OtherMEDICARE GROUP PTAN
VAC05954OtherMEDICARE GROUP PTAN