1568441731 NPI number — CYNTHIA J HARDWICK PHD

Table of content: CYNTHIA J HARDWICK PHD (NPI 1568441731)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568441731 NPI number — CYNTHIA J HARDWICK PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARDWICK
Provider First Name:
CYNTHIA
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568441731
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 PARKVIEW AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAYETTEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28305-4908
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-485-1819
Provider Business Mailing Address Fax Number:
910-485-1870

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 PARKVIEW AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAYETTEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28305-4908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-485-1819
Provider Business Practice Location Address Fax Number:
910-485-1870
Provider Enumeration Date:
01/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  2100 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 6177283 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 175225 . This is a "COMPSYCH" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 6107283 . This is a "MAILHANDLER'S BENEFIT PLA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: A3057 . This is a "MEDCOST" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 122416 . This is a "VALUE OPTIONS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 0339B . This is a "BCBS OF NC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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