Provider Demographics
NPI:1932279189
Name:CASEY, CYNTHIA K
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:K
Last Name:CASEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:K
Other - Last Name:GARRITY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3458 NEELY RD
Mailing Address - Street 2:87TH MEDICAL GROUP/SGHQ
Mailing Address - City:JOINT BASE MCGUIRE-DIX-LAKEHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:08641
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3458 NEELY RD
Practice Address - Street 2:87TH MEDICAL GROUP/SGHQ
Practice Address - City:JOINT BASE MCGUIRE-DIX-LAKEHURST
Practice Address - State:NJ
Practice Address - Zip Code:08641
Practice Address - Country:US
Practice Address - Phone:609-754-9212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01172000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist