Provider Demographics
NPI:1598763526
Name:LEWIS, CYNTHIA E (PT)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:E
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:CYNTHIA
Other - Middle Name:E
Other - Last Name:EDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:4600 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212
Mailing Address - Country:US
Mailing Address - Phone:513-351-9494
Mailing Address - Fax:513-351-0707
Practice Address - Street 1:4600 SMITH RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-2793
Practice Address - Country:US
Practice Address - Phone:513-351-9494
Practice Address - Fax:513-351-0707
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 09372225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2511553Medicaid
OH2511553Medicaid
OHLE4138941Medicare ID - Type Unspecified