Provider Demographics
NPI:1619105319
Name:DECASTRIS, CHRISTINA NOEL (PTA)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:NOEL
Last Name:DECASTRIS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:CHRISTINA
Other - Middle Name:NOEL
Other - Last Name:ROCCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:PO BOX 467
Mailing Address - Street 2:
Mailing Address - City:TALLMAN
Mailing Address - State:NY
Mailing Address - Zip Code:10982-0467
Mailing Address - Country:US
Mailing Address - Phone:914-325-5741
Mailing Address - Fax:
Practice Address - Street 1:260 N LITTLE TOR RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-2627
Practice Address - Country:US
Practice Address - Phone:914-325-5741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006987-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant