Provider Demographics
NPI:1275512139
Name:MANYAK, CHRISTINE M (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:MANYAK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5 NEPONSET ST FL ST2
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2714
Mailing Address - Country:US
Mailing Address - Phone:508-368-5532
Mailing Address - Fax:508-721-1102
Practice Address - Street 1:385 SOUTHBRIDGE ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-2498
Practice Address - Country:US
Practice Address - Phone:508-721-1101
Practice Address - Fax:508-721-1102
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7467225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
7038566OtherAETNA US HEALTHCARE
785958OtherMVP HEALTH CARE
43208OtherFALLON COMMUNITY HEALTH
A052AOtherHARVARD PILGRIM HEALTHCAR
Y68460OtherMEDICARE B
2779432OtherCIGNA HEALTH PLAN
042472266OtherHEALTHCARE VALUE MANAGEME
042472266OtherPRIVATE HEALTHCARE SYSTEM
042472266OtherTHREE RIVERS
MA0318957Medicaid
Y67940OtherBLUE SHIELD HMO BLUE
Y67940OtherBLUE SHIELD INDEMNITY
042472266OtherONE HEALTH PLAN
2779432001OtherCIGNA PAL ID
Y67940OtherBLUE CARE ELECT
0318957OtherMEDICAID WELFARE
35481155OtherCIGNA HEALTHSOURCE
45959OtherCHILDRENS MEDICAL SECURIT
650017413OtherRAILROAD MEDICARE
MA0318957Medicaid