Provider Demographics
NPI:1487050258
Name:MAREK, CINDY
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:MAREK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3492 MORGANS MILL RD
Mailing Address - Street 2:
Mailing Address - City:GOODVIEW
Mailing Address - State:VA
Mailing Address - Zip Code:24095-2820
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3492 MORGANS MILL RD
Practice Address - Street 2:
Practice Address - City:GOODVIEW
Practice Address - State:VA
Practice Address - Zip Code:24095-2820
Practice Address - Country:US
Practice Address - Phone:540-521-9493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA031000059174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist