Provider Demographics
NPI:1366679169
Name:HECTOR, CHRISTINA (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:HECTOR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:470 PROSPECT AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-4106
Mailing Address - Country:US
Mailing Address - Phone:617-817-0456
Mailing Address - Fax:
Practice Address - Street 1:470 PROSPECT AVE STE 302
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-4106
Practice Address - Country:US
Practice Address - Phone:973-520-0302
Practice Address - Fax:973-306-0703
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09169600207QS0010X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ161628Medicare PIN