Provider Demographics
NPI:1396022406
Name:TRIANTAFILIDIS, CHRISTINA (PT, ATC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:TRIANTAFILIDIS
Suffix:
Gender:F
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 DEFENSE HWY STE 150
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-8953
Mailing Address - Country:US
Mailing Address - Phone:443-481-1140
Mailing Address - Fax:
Practice Address - Street 1:8638 VETERANS HWY FL 1
Practice Address - Street 2:
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108
Practice Address - Country:US
Practice Address - Phone:443-481-1140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-03
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT021761225100000X
NJ40QA01519500225100000X
DCPT871466225100000X
MD26193225100000X
VA2305207199225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist