Provider Demographics
NPI:1134361090
Name:BENTREWICZ, CHRISTINA (PT, DPT)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:BENTREWICZ
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 1:616 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-1625
Mailing Address - Country:US
Mailing Address - Phone:908-272-3818
Mailing Address - Fax:908-654-4258
Practice Address - Street 1:525 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2534
Practice Address - Country:US
Practice Address - Phone:908-654-4252
Practice Address - Fax:908-654-4258
Is Sole Proprietor?:No
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01001200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ087731Medicare UPIN