Provider Demographics
NPI:1245395615
Name:HUBERT, CYNTHIA (PT)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:
Last Name:HUBERT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:384 MERROW RD STE B
Mailing Address - Street 2:
Mailing Address - City:TOLLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06084-3971
Mailing Address - Country:US
Mailing Address - Phone:860-875-4816
Mailing Address - Fax:
Practice Address - Street 1:384 MERROW RD STE B
Practice Address - Street 2:
Practice Address - City:TOLLAND
Practice Address - State:CT
Practice Address - Zip Code:06084-3971
Practice Address - Country:US
Practice Address - Phone:860-875-4816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2011-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1694225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT080001694CT01OtherBLUE CROSS
CTA685551OtherOXFORD
CTOV1704OtherHEALTHNET
CT552280OtherAETNA
CT650013586OtherRAILROAD MEDICARE
CT080001694CT01OtherBLUE CROSS