Provider Demographics
NPI:1629427893
Name:ORGERA, CHRISTIANA (ATC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTIANA
Middle Name:
Last Name:ORGERA
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 KINGS HWY APT A
Mailing Address - Street 2:
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-1205
Mailing Address - Country:US
Mailing Address - Phone:484-925-4346
Mailing Address - Fax:
Practice Address - Street 1:1800 KINGS HWY APT A
Practice Address - Street 2:
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-1205
Practice Address - Country:US
Practice Address - Phone:484-925-4346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0738112471599342255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ71040624Medicaid