Provider Demographics
NPI:1699943696
Name:POKNIS, CYNTHIA LOUISE (MPT)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LOUISE
Last Name:POKNIS
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 1:2009 DEACON DR UNIT 2
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-9074
Mailing Address - Country:US
Mailing Address - Phone:724-837-6499
Mailing Address - Fax:724-537-0387
Practice Address - Street 1:5500 BROOKTREE ROAD SUITE 102
Practice Address - Street 2:REHABCARE
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9260
Practice Address - Country:US
Practice Address - Phone:724-837-6499
Practice Address - Fax:724-940-3969
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT008244L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA19162Medicaid