Provider Demographics
NPI:1598858342
Name:POSER, CYNTHIA MARINO (MPT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MARINO
Last Name:POSER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2470 N DECATUR BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-2981
Mailing Address - Country:US
Mailing Address - Phone:702-338-6694
Mailing Address - Fax:702-247-1446
Practice Address - Street 1:2470 N DECATUR BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-2981
Practice Address - Country:US
Practice Address - Phone:702-338-6694
Practice Address - Fax:702-247-1446
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV812174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100509571Medicaid