Provider Demographics
NPI:1124247663
Name:OCEANAK, CYNTHIA (DC CN)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:OCEANAK
Suffix:
Gender:F
Credentials:DC CN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 186
Mailing Address - Street 2:2 QUARRY LANE
Mailing Address - City:UPPER BLACK EDDY
Mailing Address - State:PA
Mailing Address - Zip Code:18972-0186
Mailing Address - Country:US
Mailing Address - Phone:610-982-5966
Mailing Address - Fax:610-982-0195
Practice Address - Street 1:2 QUARRY LANE
Practice Address - Street 2:
Practice Address - City:UPPER BLACK EDDY
Practice Address - State:PA
Practice Address - Zip Code:18972
Practice Address - Country:US
Practice Address - Phone:610-982-5966
Practice Address - Fax:610-982-0195
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA223091682111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA075762OtherMEDICARE PROVIDER
PA666192SC4Medicare UPIN