Provider Demographics
NPI:1407387384
Name:BRENDLE, CYNTHIA (PTA)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:BRENDLE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MS
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:BRENDLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PTA
Mailing Address - Street 1:319 MEALEY PKWY
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-3433
Mailing Address - Country:US
Mailing Address - Phone:717-521-4229
Mailing Address - Fax:
Practice Address - Street 1:19800 TRANQUILITY CIRCLE
Practice Address - Street 2:ROBINWOOD CAMPUS
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742
Practice Address - Country:US
Practice Address - Phone:240-420-4133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI001058208100000X
MDA2446225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1407387384Medicaid