Provider Demographics
NPI:1871662296
Name:BROPHY, CHRISTA EILEEN (OTR)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:EILEEN
Last Name:BROPHY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 NUMIDIA DR
Mailing Address - Street 2:
Mailing Address - City:CATAWISSA
Mailing Address - State:PA
Mailing Address - Zip Code:17820-7901
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:104 N 16TH ST
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-1228
Practice Address - Country:US
Practice Address - Phone:570-524-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008055174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist