Provider Demographics
NPI:1518059575
Name:SOCHA-GELGOT, CYNTHIA S (PHD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:S
Last Name:SOCHA-GELGOT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2173 EMBASSY DR
Mailing Address - Street 2:SUITE 366
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603
Mailing Address - Country:US
Mailing Address - Phone:717-392-6061
Mailing Address - Fax:717-431-2014
Practice Address - Street 1:2173 EMBASSY DR
Practice Address - Street 2:SUITE 366
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603
Practice Address - Country:US
Practice Address - Phone:717-392-6061
Practice Address - Fax:717-431-2014
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006927L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50012915OtherBLUE CROSS ID
PA483298OtherBLUE SHIELD ID
PAGE483298Medicare ID - Type UnspecifiedMEDICARE
PA483298OtherBLUE SHIELD ID