Provider Demographics
NPI:1659613081
Name:JUNGKURTH, CHRISTINE (RPT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:JUNGKURTH
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 OCEAN PKWY
Mailing Address - Street 2:17U
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-2567
Mailing Address - Country:US
Mailing Address - Phone:718-633-1888
Mailing Address - Fax:
Practice Address - Street 1:135 OCEAN PKWY
Practice Address - Street 2:17U
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-2567
Practice Address - Country:US
Practice Address - Phone:718-633-1888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-24
Last Update Date:2013-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002599-1225100000X, 2251G0304X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics