Provider Demographics
NPI:1346485117
Name:SHINNERS, CHRISTA MARIE (MS PT)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:MARIE
Last Name:SHINNERS
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-4212
Mailing Address - Country:US
Mailing Address - Phone:718-815-4930
Mailing Address - Fax:
Practice Address - Street 1:22 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-4212
Practice Address - Country:US
Practice Address - Phone:718-815-4930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0202142251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics