Provider Demographics
NPI:1851488142
Name:ALLEN, CHRISTOPHER (PT)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:
Last Name:ALLEN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 HUNTER BROOK LN
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-5858
Mailing Address - Country:US
Mailing Address - Phone:518-793-0891
Mailing Address - Fax:518-793-2936
Practice Address - Street 1:3 HUNTER BROOK LN
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-5858
Practice Address - Country:US
Practice Address - Phone:518-793-0891
Practice Address - Fax:518-793-2936
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0249921225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000416641001OtherBLUE SHIELD
Q10U91OtherBLUE CROSS
Q23404Medicare UPIN
Q10U91OtherBLUE CROSS