Provider Demographics
NPI:1891835005
Name:ANSINK, CINDY PANZA
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:PANZA
Last Name:ANSINK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-2808
Mailing Address - Country:US
Mailing Address - Phone:631-754-5989
Mailing Address - Fax:631-754-7559
Practice Address - Street 1:53 5TH AVE
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-2808
Practice Address - Country:US
Practice Address - Phone:631-754-5989
Practice Address - Fax:631-754-7559
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004452225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist