Provider Demographics
NPI:1134591605
Name:OLIVER, CHRISTINE (MA,BA)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:OLIVER
Suffix:
Gender:F
Credentials:MA,BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 E MAIN ST
Mailing Address - Street 2:4TH FLOOR ADMINISTRATION
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-2310
Mailing Address - Country:US
Mailing Address - Phone:203-574-9000
Mailing Address - Fax:203-574-9006
Practice Address - Street 1:54 SOUTH MAIN STREET
Practice Address - Street 2:NEWTOWN CLINICAL SERVICES
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06710-2169
Practice Address - Country:US
Practice Address - Phone:203-270-5564
Practice Address - Fax:203-270-5514
Is Sole Proprietor?:No
Enumeration Date:2015-10-23
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program