Provider Demographics
NPI:1407188725
Name:ALLEN, CYNTHIA L (LMT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 CHAMBERLAIN RD
Mailing Address - Street 2:
Mailing Address - City:HONEOYE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14472-9728
Mailing Address - Country:US
Mailing Address - Phone:585-794-6900
Mailing Address - Fax:
Practice Address - Street 1:167 CHAMBERLAIN RD
Practice Address - Street 2:
Practice Address - City:HONEOYE FALLS
Practice Address - State:NY
Practice Address - Zip Code:14472-9728
Practice Address - Country:US
Practice Address - Phone:585-794-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016165-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist