Provider Demographics
NPI:1437403664
Name:CHRISTINE L TRAGESSER
Entity Type:Organization
Organization Name:CHRISTINE L TRAGESSER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ULTRASOUND/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:TRAGESSER
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS, RUT
Authorized Official - Phone:412-427-1093
Mailing Address - Street 1:4463 BULLTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-9505
Mailing Address - Country:US
Mailing Address - Phone:412-427-1093
Mailing Address - Fax:412-461-4720
Practice Address - Street 1:4463 BULLTOWN RD
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-9505
Practice Address - Country:US
Practice Address - Phone:412-427-1093
Practice Address - Fax:412-461-4720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-09
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAROMS#238802085U0001X, 261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty