Provider Demographics
NPI:1891191318
Name:PORFILIO, CYNTHIA L (MPT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:PORFILIO
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 1:350 NEW FIDELITY CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2665
Mailing Address - Country:US
Mailing Address - Phone:336-584-5544
Mailing Address - Fax:919-313-1276
Practice Address - Street 1:1236 HUFFMAN MILL RD
Practice Address - Street 2:SUITE 1300
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8700
Practice Address - Country:US
Practice Address - Phone:336-584-5544
Practice Address - Fax:919-313-1276
Is Sole Proprietor?:No
Enumeration Date:2014-11-11
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP8344225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP8344OtherNORTH CAROLINA PHYSICAL THERAPY LICENSE