Provider Demographics
NPI:1255651147
Name:SOLANG, CHRISTEEN BAGUILAT (PT)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTEEN
Middle Name:BAGUILAT
Last Name:SOLANG
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 1:350 NEW FIDELITY CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2665
Mailing Address - Country:US
Mailing Address - Phone:919-258-2714
Mailing Address - Fax:410-648-4878
Practice Address - Street 1:400 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:DE
Practice Address - Zip Code:19956-1571
Practice Address - Country:US
Practice Address - Phone:302-280-6953
Practice Address - Fax:302-715-5001
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0002663225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE80003642OtherAMERIHEALTH & KEYSTONE VIP
DE1255651147Medicaid
DEAC44-0053OtherCAREFIRST
DEP01111295OtherRAILROAD MEDICARE
DE2566859OtherBC BS DE
DE30096408OtherAMERIHEALTH & KEYSTONE FIRST
DE1255651147Medicaid