Provider Demographics
NPI:1891405502
Name:CHRISSIS, CARA LYNN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:CARA
Middle Name:LYNN
Last Name:CHRISSIS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 ASTORIA BLVD APT 3C
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-1943
Mailing Address - Country:US
Mailing Address - Phone:603-930-8500
Mailing Address - Fax:
Practice Address - Street 1:2717 CRESCENT ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-2507
Practice Address - Country:US
Practice Address - Phone:718-545-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049363225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist