Cynthia Lyn Pantol, MASTERS

Primary specialty

SpecialistTaxonomy code 174400000X

License

630650051 Issued in NY

Practice address

214 Bernstein Blvd
Center Moriches, NY 11934-1402

Phone

(631) 909-2243

NPI assigned

Jun 22, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1588927677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 BERNSTEIN BLVD",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "119341402",
            "telephone_number": "631-909-2243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 BERNSTEIN BLVD",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "119341402",
            "telephone_number": "631-909-2243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTOL",
        "first_name": "CYNTHIA",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "MASTERS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "2427",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "001757",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "630650051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stefanie Ortiz
• Laura Otton
• Out East Therapy of New York for OT, PT, SLP, RN and Psychology Servic
• Out East Therapy of New York for OT, PT, SLP, RN and Psychology Servic
• Mark Pandolfi, LMSW
• Kerry Christine Paras, PH.D.
• Linda Ann Pelosi, R-LCSW
• Gregory Petrucci
• Physical Medicine of Suffolk, LLP
• Andrew Alan Plastrik, MS, SLP

• Specialist in Center Moriches, NY
• Providers in Center Moriches, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.