Provider Demographics
NPI:1780819763
Name:ALT, CHRISTINA FLUEHR (PA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:FLUEHR
Last Name:ALT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 BELAMOUR DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON CROSSING
Mailing Address - State:PA
Mailing Address - Zip Code:18977-1368
Mailing Address - Country:US
Mailing Address - Phone:484-744-0431
Mailing Address - Fax:
Practice Address - Street 1:MCCOSH HEALTH CENTER PRINCETON UNIVERSITY
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08544-3118
Practice Address - Country:US
Practice Address - Phone:609-258-3141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA002204L363A00000X
NJ25MP00389200363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA440771OtherMLHC MEDICARE GROUP AA #
PA440771OtherMLHC MEDICARE GROUP AA #