Provider Demographics
NPI:1396846291
Name:PORTER, CYNTHIA J (PT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:J
Last Name:PORTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:J
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:306 N MAIN ST STE 5
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-4353
Mailing Address - Country:US
Mailing Address - Phone:603-335-4700
Mailing Address - Fax:603-335-4704
Practice Address - Street 1:306 N MAIN ST STE 5
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-4353
Practice Address - Country:US
Practice Address - Phone:603-335-4700
Practice Address - Fax:603-335-4704
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2977225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0708062OtherMASSHEALTH
NH3661056OtherAETNA
NH4130795OtherMVP
NH08Y007648NH01OtherANTHEM
NH31567384OtherTRICARE
NH30393163Medicaid
NH4130795OtherMVP