Provider Demographics
NPI:1104134717
Name:MCCREARY, CINDY LOUISE (PT)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:LOUISE
Last Name:MCCREARY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8629 LYDIA LN
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:NY
Mailing Address - Zip Code:13039-7843
Mailing Address - Country:US
Mailing Address - Phone:315-699-3559
Mailing Address - Fax:
Practice Address - Street 1:8629 LYDIA LN
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:NY
Practice Address - Zip Code:13039-7843
Practice Address - Country:US
Practice Address - Phone:315-699-3559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015956-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics