Provider Demographics
NPI:1699552471
Name:MUNIZ, CINDY ILENE (PTA)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:ILENE
Last Name:MUNIZ
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:ILENE
Other - Last Name:MUNIZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT ASSISTANT
Mailing Address - Street 1:317 MORNING GLORY DR
Mailing Address - Street 2:
Mailing Address - City:MONROE TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-5338
Mailing Address - Country:US
Mailing Address - Phone:631-766-9522
Mailing Address - Fax:
Practice Address - Street 1:317 MORNING GLORY DR
Practice Address - Street 2:
Practice Address - City:MONROE TWP
Practice Address - State:NJ
Practice Address - Zip Code:08831-5338
Practice Address - Country:US
Practice Address - Phone:631-766-9522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00222100225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant