Provider Demographics
NPI:1215001482
Name:CINDI A. PRENTISS, PT.,PC.
Entity Type:Organization
Organization Name:CINDI A. PRENTISS, PT.,PC.
Other - Org Name:PHYSICAL THERAPY & BEYOND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CINDI
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRENTISS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:631-941-3535
Mailing Address - Street 1:196 BELLE MEAD RD
Mailing Address - Street 2:STE 2 AND 3
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3477
Mailing Address - Country:US
Mailing Address - Phone:631-941-3535
Mailing Address - Fax:631-941-3599
Practice Address - Street 1:196 BELLE MEAD RD
Practice Address - Street 2:STE 2 AND 3
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3477
Practice Address - Country:US
Practice Address - Phone:631-941-3535
Practice Address - Fax:631-941-3599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ5W3B1Medicare ID - Type Unspecified