Basic Information
| Provider Information | |||||||||
| NPI: | 1851992788 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MENTCH | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 325 S HIGHLAND AVE APT 102 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152064288 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176459262 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3053 NEW GERMANY RD | ||||||||
| Address2: | |||||||||
| City: | EBENSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 159313516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144721100 | ||||||||
| FaxNumber: | 8144726445 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2020 | ||||||||
| LastUpdateDate: | 11/06/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT028975 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.