Provider Demographics
NPI:1750524641
Name:THOMSON, CYNTHIA J (PA)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:J
Last Name:THOMSON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3010
Mailing Address - Country:US
Mailing Address - Phone:540-450-3339
Mailing Address - Fax:540-450-3338
Practice Address - Street 1:1440 AMHERST ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3010
Practice Address - Country:US
Practice Address - Phone:540-450-3339
Practice Address - Fax:540-450-3338
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-08
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00798568OtherRR MEDICARE
VAP00798568OtherRR MEDICARE