Provider Demographics
NPI:1639115751
Name:BECK, CHRISTINE H (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:H
Last Name:BECK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CORPORATE DR
Mailing Address - Street 2:SUITE #6
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-2664
Mailing Address - Country:US
Mailing Address - Phone:610-250-9666
Mailing Address - Fax:610-250-9606
Practice Address - Street 1:21 CORPORATE DR
Practice Address - Street 2:SUITE #6
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-2664
Practice Address - Country:US
Practice Address - Phone:610-250-9666
Practice Address - Fax:610-250-9606
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD026690E225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
2162585OtherAETNA
1515001OtherGATEWAY
PA02280600OtherCAP BC
NJ7924003Medicaid
PABE1604181OtherHIGHMARK BS
PA0009605540004Medicaid
20047382OtherAMERIHEALTH MERCY
NJ023284Medicare ID - Type Unspecified
NJ7924003Medicaid
C26042Medicare UPIN