Provider Demographics
NPI:1528066412
Name:MALINOWSKI-DIAZ, CYNTHIA L (MPT)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:L
Last Name:MALINOWSKI-DIAZ
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 MAMARONECK AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-5224
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 WEST AVE STE 101
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2041
Practice Address - Country:US
Practice Address - Phone:215-886-5520
Practice Address - Fax:215-886-5523
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT010609L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
232667866008OtherTRICARE
001693813OtherHIGHMARK
12299099OtherMULTIPLAN