Provider Demographics
NPI:1629223375
Name:CHRISTINA KASSAP PT PC
Entity Type:Organization
Organization Name:CHRISTINA KASSAP PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KASSAP
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:516-764-2189
Mailing Address - Street 1:389 DEMOTT AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-1810
Mailing Address - Country:US
Mailing Address - Phone:516-764-2189
Mailing Address - Fax:516-764-2189
Practice Address - Street 1:389 DEMOTT AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-1810
Practice Address - Country:US
Practice Address - Phone:516-764-2189
Practice Address - Fax:516-764-2189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-21
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024501225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty