Provider Demographics
NPI:1083119739
Name:SWENTOWSKY, CHRISTINA (PTA)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:SWENTOWSKY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 UNION ST
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-2339
Mailing Address - Country:US
Mailing Address - Phone:609-500-3754
Mailing Address - Fax:
Practice Address - Street 1:255 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-2982
Practice Address - Country:US
Practice Address - Phone:856-235-1214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00286600225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant