Provider Demographics
NPI:1336321934
Name:BEACHER, CHRISTINE A (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:BEACHER
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 1:4 GRANADA DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-5834
Mailing Address - Country:US
Mailing Address - Phone:518-937-0457
Mailing Address - Fax:518-930-2579
Practice Address - Street 1:4 GRANADA DR
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-5834
Practice Address - Country:US
Practice Address - Phone:518-937-0457
Practice Address - Fax:518-930-2579
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-05
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029730225100000X, 252Y00000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics