Provider Demographics
NPI:1003802919
Name:BLANCHARD, CHRISTINA JANE (BSPT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:JANE
Last Name:BLANCHARD
Suffix:
Gender:F
Credentials:BSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 TRIANGLE RD UNIT 229
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-8102
Mailing Address - Country:US
Mailing Address - Phone:908-681-5045
Mailing Address - Fax:908-681-5029
Practice Address - Street 1:220 TRIANGLE RD UNIT 229
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-8102
Practice Address - Country:US
Practice Address - Phone:908-681-5045
Practice Address - Fax:908-681-5029
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2024-01-10
Deactivation Date:2006-03-24
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00670000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ097538Medicare ID - Type Unspecified