Provider Demographics
NPI:1659770196
Name:NEGRIN, CYNTHIA M (LICENCED MASSAGE THE)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:NEGRIN
Suffix:
Gender:F
Credentials:LICENCED MASSAGE THE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 70012
Mailing Address - Street 2:PMB #104
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738
Mailing Address - Country:US
Mailing Address - Phone:787-902-3060
Mailing Address - Fax:
Practice Address - Street 1:A-18 CALLE J #
Practice Address - Street 2:URBANIZACION MONTE BRISAS
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:787-902-3060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
#0589225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist