Provider Demographics
NPI:1588752992
Name:CYNTHIA K. RECINTO, MD, PC
Entity type:Organization
Organization Name:CYNTHIA K. RECINTO, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:RECINTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-398-2600
Mailing Address - Street 1:990 THOMPSON ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY SHORE
Mailing Address - State:PA
Mailing Address - Zip Code:17740-1727
Mailing Address - Country:US
Mailing Address - Phone:570-398-2600
Mailing Address - Fax:570-398-2055
Practice Address - Street 1:990 THOMPSON ST
Practice Address - Street 2:
Practice Address - City:JERSEY SHORE
Practice Address - State:PA
Practice Address - Zip Code:17740-1727
Practice Address - Country:US
Practice Address - Phone:570-398-2600
Practice Address - Fax:570-398-2055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD070444L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA002607OtherFIRST PRIORITY HEALTH
PA110229732OtherRAILROAD MEDICARE
PWC236OtherGEISINGER HEALTH PLAN
PA00152413OtherBLUE CROSS/BLUE SHIELD
PA00152413OtherBLUE CROSS/BLUE SHIELD
PA00152413OtherBLUE CROSS/BLUE SHIELD
PA038936Medicare ID - Type Unspecified