Provider Demographics
NPI:1376102061
Name:INGA, CINDY MARIELA (MD)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:MARIELA
Last Name:INGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 MACK BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-5622
Mailing Address - Country:US
Mailing Address - Phone:570-790-2391
Mailing Address - Fax:
Practice Address - Street 1:5683 ROUTE 115
Practice Address - Street 2:
Practice Address - City:BLAKESLEE
Practice Address - State:PA
Practice Address - Zip Code:18610-7973
Practice Address - Country:US
Practice Address - Phone:570-355-7100
Practice Address - Fax:570-422-8076
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-07
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD478946207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103724929-0002Medicaid