Provider Demographics
NPI:1275953622
Name:JOY, CHRISTINA (PTA)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:JOY
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 1:54 SUNNYSIDE TER
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-4232
Mailing Address - Country:US
Mailing Address - Phone:203-913-6622
Mailing Address - Fax:
Practice Address - Street 1:54 SUNNYSIDE TER
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-4232
Practice Address - Country:US
Practice Address - Phone:203-913-6622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001333225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant