Provider Demographics
NPI:1760760375
Name:NESTORY, CHRISTINA ANN
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:ANN
Last Name:NESTORY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 N KINDERKAMACK RD
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-2147
Mailing Address - Country:US
Mailing Address - Phone:551-427-2477
Mailing Address - Fax:
Practice Address - Street 1:50 N KINDERKAMACK RD
Practice Address - Street 2:
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-2147
Practice Address - Country:US
Practice Address - Phone:551-427-2477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-31
Last Update Date:2011-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ510418222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist