Provider Demographics
NPI:1831168582
Name:CENDANA, GYL I (PA C)
Entity type:Individual
Prefix:
First Name:GYL
Middle Name:I
Last Name:CENDANA
Suffix:
Gender:M
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 VAN VOORHIS RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505
Mailing Address - Country:US
Mailing Address - Phone:304-598-1122
Mailing Address - Fax:304-598-1124
Practice Address - Street 1:1160 VAN VOORHIS RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505
Practice Address - Country:US
Practice Address - Phone:304-598-1122
Practice Address - Fax:304-598-1124
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV323363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV323OtherTHE HEALTH PLAN
P00207974OtherRAILROAD MEDICARE
124508400OtherDEPT OF LABOR WORK COMP
Q22012OtherCARELINK
1424801OtherUMWA
311545097Other4MOST
001714978OtherMT STATE BLUE CROSS BLUE
311545097OtherPEIA
198177OtherFEDERAL BLACK LUNG
001714978OtherMT STATE BLUE CROSS BLUE
WV323OtherTHE HEALTH PLAN
Q22012OtherCARELINK
198177OtherFEDERAL BLACK LUNG