Provider Demographics
NPI:1750672531
Name:ELAINE P. CHRISTIE
Entity Type:Organization
Organization Name:ELAINE P. CHRISTIE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:P
Authorized Official - Last Name:CHRISTIE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:484-442-8833
Mailing Address - Street 1:1215 W BALTIMORE PIKE
Mailing Address - Street 2:SUITE 13
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5540
Mailing Address - Country:US
Mailing Address - Phone:484-442-8833
Mailing Address - Fax:
Practice Address - Street 1:1215 W BALTIMORE PIKE
Practice Address - Street 2:SUITE 13
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5540
Practice Address - Country:US
Practice Address - Phone:484-442-8833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002013152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty