Provider Demographics
NPI:1902130180
Name:TIMMERMANN, CINDI J (MSW)
Entity Type:Individual
Prefix:MISS
First Name:CINDI
Middle Name:J
Last Name:TIMMERMANN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 PECONIC ST
Mailing Address - Street 2:APT 5-1B
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-7100
Mailing Address - Country:US
Mailing Address - Phone:631-676-5974
Mailing Address - Fax:
Practice Address - Street 1:500 PECONIC ST
Practice Address - Street 2:APT 5-1B
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-7100
Practice Address - Country:US
Practice Address - Phone:631-676-5974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker