Provider Demographics
NPI:1588631519
Name:THOMPSON, CHRISTINE JEAN (PT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:JEAN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 LOCKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-4508
Mailing Address - Country:US
Mailing Address - Phone:516-694-2534
Mailing Address - Fax:516-694-2534
Practice Address - Street 1:1554 NORTHERN BLVD
Practice Address - Street 2:FOURTH FLOOR
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3006
Practice Address - Country:US
Practice Address - Phone:516-627-8470
Practice Address - Fax:516-365-8941
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist