Provider Demographics
NPI:1831362128
Name:NEWMEYER, CYNTHIA KAY (MOTR)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:KAY
Last Name:NEWMEYER
Suffix:
Gender:F
Credentials:MOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 W SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-4450
Mailing Address - Country:US
Mailing Address - Phone:269-343-0760
Mailing Address - Fax:269-343-0760
Practice Address - Street 1:1001 W MAPLE ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-1843
Practice Address - Country:US
Practice Address - Phone:269-343-0760
Practice Address - Fax:269-343-0760
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201002159225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0M38570Medicare PIN