Provider Demographics
NPI:1205831518
Name:AYERS, CHRISTA L (PT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTA
Middle Name:L
Last Name:AYERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2137 HIGHWAY 35
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1083
Mailing Address - Country:US
Mailing Address - Phone:732-264-9494
Mailing Address - Fax:732-264-2502
Practice Address - Street 1:2137 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1083
Practice Address - Country:US
Practice Address - Phone:732-264-9494
Practice Address - Fax:732-264-2502
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00294700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ047876M7MMedicare PIN