Provider Demographics
NPI:1508041369
Name:KOPYAR, CYNTHIA M (PT, GCFP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:KOPYAR
Suffix:
Gender:F
Credentials:PT, GCFP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W 135TH ST APT 7A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10030-2760
Mailing Address - Country:US
Mailing Address - Phone:614-499-7551
Mailing Address - Fax:
Practice Address - Street 1:300 W 135TH ST APT 7A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10030-2760
Practice Address - Country:US
Practice Address - Phone:614-499-7551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-28
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3302225100000X
NY030106225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist