Provider Demographics
NPI:1497717300
Name:ROBERT, CHRISTINE (PT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:ROBERT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:ROBERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:771 PILOT HOUSE DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606
Mailing Address - Country:US
Mailing Address - Phone:757-873-2302
Mailing Address - Fax:757-873-2306
Practice Address - Street 1:4125 IRONBOUND RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2666
Practice Address - Country:US
Practice Address - Phone:757-220-8383
Practice Address - Fax:757-253-7833
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2011-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203336225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
7292532OtherAETNA
VAP00277057OtherRAILROAD MEDICARE
VA192935OtherBCBS PHYSICAL THERAPY
VA10090202Medicaid
7292532OtherAETNA
VAC05954Medicare PIN