Provider Demographics
NPI:1962454785
Name:LARGEY, CHRISTINE ANNE (PT, CERTMDT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:ANNE
Last Name:LARGEY
Suffix:
Gender:F
Credentials:PT, CERTMDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 ZOCCO LN
Mailing Address - Street 2:
Mailing Address - City:OCEANPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:07757-1578
Mailing Address - Country:US
Mailing Address - Phone:732-483-9292
Mailing Address - Fax:732-483-1055
Practice Address - Street 1:160 WHITE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1165
Practice Address - Country:US
Practice Address - Phone:732-977-4640
Practice Address - Fax:732-483-1055
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00570600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ69501OtherCIGNA
NJ2549445OtherUNITED HEALTHCARE
NJ2549445OtherUNITED HEALTHCARE
NJ090125U11Medicare ID - Type UnspecifiedRENDERING NUMBER