Provider Demographics
NPI:1144390931
Name:MCARDLE, CHRISTEEN L (PA)
Entity Type:Individual
Prefix:
First Name:CHRISTEEN
Middle Name:L
Last Name:MCARDLE
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 1:197 ADAMS RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01267-2930
Mailing Address - Country:US
Mailing Address - Phone:413-664-5900
Mailing Address - Fax:413-664-5731
Practice Address - Street 1:77 HOSPITAL AVE STE 300
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-2538
Practice Address - Country:US
Practice Address - Phone:413-664-5959
Practice Address - Fax:413-664-5773
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA3826363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP79913Medicare UPIN
MA0013177Medicare PIN