Provider Demographics
NPI:1952424087
Name:FONGGING, CYNTHIA ARIAS (PT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ARIAS
Last Name:FONGGING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:IVONNE
Other - Last Name:ARIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:7209 E. WE HARRIS BLVD.
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227
Mailing Address - Country:US
Mailing Address - Phone:704-523-7529
Mailing Address - Fax:704-561-0850
Practice Address - Street 1:7209 E. WE HARRIS BLVD.
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227
Practice Address - Country:US
Practice Address - Phone:704-523-7529
Practice Address - Fax:704-561-0850
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10608225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist