Provider Demographics
NPI:1235374455
Name:NELSON, CHRISTI ANN (PTA)
Entity Type:Individual
Prefix:MS
First Name:CHRISTI
Middle Name:ANN
Last Name:NELSON
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 1:251 WASHINGTON AVENUE EXT
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-5504
Mailing Address - Country:US
Mailing Address - Phone:518-456-4466
Mailing Address - Fax:518-456-4536
Practice Address - Street 1:251 WASHINGTON AVENUE EXT
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-5504
Practice Address - Country:US
Practice Address - Phone:518-456-4466
Practice Address - Fax:518-456-4536
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000176-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant