Provider Demographics
NPI:1740248244
Name:WASSMUTH, CINDY M (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:M
Last Name:WASSMUTH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:38B GROVE ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4665
Mailing Address - Country:US
Mailing Address - Phone:203-438-9557
Mailing Address - Fax:203-438-6546
Practice Address - Street 1:235 MAIN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6673
Practice Address - Country:US
Practice Address - Phone:203-730-5929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002053363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
S61863Medicare UPIN