Provider Demographics
NPI:1174576623
Name:MOSES, CYNTHIA (PT)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:
Last Name:MOSES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:PALMERI-PARKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:255 ENTERPRISE BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-6300
Mailing Address - Country:US
Mailing Address - Phone:864-454-0888
Mailing Address - Fax:864-454-1130
Practice Address - Street 1:3851 HOWARD GAP RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-3102
Practice Address - Country:US
Practice Address - Phone:864-454-6670
Practice Address - Fax:864-454-6675
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP8677225100000X
SC5263225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
20-2312101OtherSELECT HEALTH
SC607756102OtherDEPT OF LABOR
SC190244OtherMEDCOST
SC20-2312101OtherUHC
SC20-2312101OtherGREAT WEST
SC20-2312101OtherFOCUS
SC20-2312101OtherCHAMPUS-TRICARE
SC20-2312101OtherDEPT OF LABOR
SC20-2312101OtherKANAWHA
SC9799717OtherCIGNA
SC20-2312101OtherTAX ID
SC607756100OtherDEPT OF LABOR
SC7761758OtherAETNA
SC20-2312101OtherBLUECHOICE
SCTH1709Medicaid
SC20-2312101OtherBCBS OF SOUTH CAROLINA
SC607756103OtherDEPT OF LABOR
SC20-2312101OtherPREMIER
SC20-2312101OtherCAROLINA CARE PLAN
20-2312101OtherSELECT HEALTH