1942390125 NPI number — MRS. CYNTHIA ANNE LAYMAN P.T.

Table of content: DOMINIQUE B SALIBA M.D. (NPI 1902870397)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942390125 NPI number — MRS. CYNTHIA ANNE LAYMAN P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAYMAN
Provider First Name:
CYNTHIA
Provider Middle Name:
ANNE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
P.T.
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:
1942390125
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/19/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 128, 500 IRVINGTON RD
Provider Second Line Business Mailing Address:
CAROUSEL PHYSICAL THERAPY, INC.
Provider Business Mailing Address City Name:
KILMARNOCK
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22482
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-435-3435
Provider Business Mailing Address Fax Number:
804-435-3682

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 IRVINGTON RD
Provider Second Line Business Practice Location Address:
CAROUSEL PHYSICAL THERAPY INC.
Provider Business Practice Location Address City Name:
KILMARNOCK
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22482
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-435-3435
Provider Business Practice Location Address Fax Number:
804-435-3682
Provider Enumeration Date:
10/16/2006

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: 225100000X , with the licence number:  2305002571 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 20091 . This is a "SENTARA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 250404 . This is a "BCBS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 009402331 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 541726590 . This is a "COMMERCIAL/WC CARRIER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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