Provider Demographics
NPI:1962461244
Name:DEANER, CHRISTINE ELIZABETH (PT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:ELIZABETH
Last Name:DEANER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 HILLVIEW DR
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-8553
Mailing Address - Country:US
Mailing Address - Phone:770-530-7082
Mailing Address - Fax:
Practice Address - Street 1:700 HAWK RIDGE DR 1
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:PA
Practice Address - Zip Code:19526
Practice Address - Country:US
Practice Address - Phone:770-534-5154
Practice Address - Fax:770-503-0183
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT007441225100000X
PADAPT003994225100000X
PAPT018566225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAQ52126Medicare UPIN
GA65BBDFLMedicare ID - Type UnspecifiedMEDICARE #