Provider Demographics
NPI:1518157650
Name:MARCHI, CYNTHIA KAKUK (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:KAKUK
Last Name:MARCHI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 MARQUETTE AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4717
Mailing Address - Country:US
Mailing Address - Phone:505-307-0849
Mailing Address - Fax:
Practice Address - Street 1:5201 ROMA AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-1334
Practice Address - Country:US
Practice Address - Phone:505-262-2311
Practice Address - Fax:505-262-2426
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1738225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1738OtherOCCUPATIONL THERAPIST STA