Provider Demographics
NPI:1407185747
Name:BECK, CHRISTINA L (PA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:L
Last Name:BECK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 412012
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-2012
Mailing Address - Country:US
Mailing Address - Phone:978-691-5691
Mailing Address - Fax:
Practice Address - Street 1:75 WASHINGTON ST STE 200
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1795
Practice Address - Country:US
Practice Address - Phone:781-878-6495
Practice Address - Fax:781-878-6524
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-16
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA22958363AM0700X
MAPA7880363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical