Provider Demographics
NPI:1326766692
Name:TEDESCHI, CHRISTINA (DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:TEDESCHI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 ROUTE 88
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3153
Mailing Address - Country:US
Mailing Address - Phone:732-965-7900
Mailing Address - Fax:732-475-7666
Practice Address - Street 1:1930 ROUTE 88
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3153
Practice Address - Country:US
Practice Address - Phone:732-965-7900
Practice Address - Fax:732-475-7666
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02113400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist