Provider Demographics
NPI:1336507490
Name:NIEMANN, CHRISTOPHER PATRICK JR (DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:PATRICK
Last Name:NIEMANN
Suffix:JR
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 HADDON AVE
Mailing Address - Street 2:
Mailing Address - City:WEST BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08091-1944
Mailing Address - Country:US
Mailing Address - Phone:267-250-0443
Mailing Address - Fax:
Practice Address - Street 1:91 HADDON AVE
Practice Address - Street 2:
Practice Address - City:WEST BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08091-1944
Practice Address - Country:US
Practice Address - Phone:267-250-0443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist