Provider Demographics
NPI:1710176052
Name:TUSKE, CHRISTY M (PAC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTY
Middle Name:M
Last Name:TUSKE
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:M
Other - Last Name:NIEMKIEWICZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1754
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18105-1754
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18941 JOHN J WILLIAMS HWY
Practice Address - Street 2:
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-4404
Practice Address - Country:US
Practice Address - Phone:302-645-3010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDA-0013563363AM0700X
PAMA053208363AM0700X
DEC5-0001292363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical