Provider Demographics
NPI:1407328552
Name:HERING, CYNTHIA GRACE (PTA)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:GRACE
Last Name:HERING
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10222 WHITE PELICAN WAY
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:MD
Mailing Address - Zip Code:21774-2909
Mailing Address - Country:US
Mailing Address - Phone:301-639-9974
Mailing Address - Fax:
Practice Address - Street 1:3200 BAKER CIR
Practice Address - Street 2:
Practice Address - City:ADAMSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21710-9653
Practice Address - Country:US
Practice Address - Phone:301-644-1646
Practice Address - Fax:410-549-0133
Is Sole Proprietor?:No
Enumeration Date:2018-12-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA4238225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant