Provider Demographics
NPI:1295715670
Name:DOOLEY, CHRISTINE R (PT)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:R
Last Name:DOOLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:5 NEPONSET ST FL ST2
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2714
Mailing Address - Country:US
Mailing Address - Phone:508-368-5532
Mailing Address - Fax:508-853-1907
Practice Address - Street 1:50 GOLD STAR BLVD
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01606
Practice Address - Country:US
Practice Address - Phone:508-856-9510
Practice Address - Fax:508-853-1907
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA4697225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0345911Medicaid
42396OtherFALLON COMMUNITY HEALTH P
042472266OtherPRIVATE HEALTHCARE SYSTEM
Y68458OtherMEDICARE B
AA4052OtherHARVARD PILGRIM HEALTHCAR
Y67945OtherBLUE CARE ELECT
042472266OtherONE HEALTH PLAN
2779432OtherCIGNA HEALTH PLAN
2779432001OtherCIGNA PAL ID REFERRAL #
35481155OtherCIGNA HEALTHSOURCE
042472266OtherHEALTHCARE VALUE MANAGEME
650017421OtherRAILROAD MEDICARE
785952OtherMVP HEALTH CARE
Y67945OtherBLUE SHIELD IDEMNITY
042472266OtherTHREE RIVERS
7367600OtherAETNA US HEALTHCARE
Y67945OtherBLUE SHIELD HMO BLUE
2779432OtherCIGNA HEALTH PLAN