Provider Demographics
NPI:1417094004
Name:CHESELKA, CHRISTINA MARIE (RT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:CHESELKA
Suffix:
Gender:F
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-5235
Mailing Address - Country:US
Mailing Address - Phone:732-495-4955
Mailing Address - Fax:
Practice Address - Street 1:41 OHIO AVENUE
Practice Address - Street 2:
Practice Address - City:NORTH MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748
Practice Address - Country:US
Practice Address - Phone:732-495-4955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ6240122471R0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471R0002XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiation Therapy