Provider Demographics
NPI:1750645602
Name:KWIK, CHRISTINE IRENE (MD)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:IRENE
Last Name:KWIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:CHRISTINE
Other - Middle Name:IRENE
Other - Last Name:KWIK-KOSTEK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8303 TULPEHOCKEN AVE
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-1909
Mailing Address - Country:US
Mailing Address - Phone:215-782-8693
Mailing Address - Fax:
Practice Address - Street 1:8303 TULPEHOCKEN AVE
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-1909
Practice Address - Country:US
Practice Address - Phone:215-782-8693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD034987L208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice