Provider Demographics
NPI:1356376511
Name:MOLLOY, CHRISTINE A (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:MOLLOY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:785 5TH AVENUE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4217
Practice Address - Street 1:12 ST PAUL DR STE 207
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1035
Practice Address - Country:US
Practice Address - Phone:717-217-6882
Practice Address - Fax:717-217-6883
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD072147L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001846634 0002Medicaid
PA1341698OtherAETNA HMO
PA25-1716306OtherMULTIPLAN/PHCS
PA120420413OtherDEPT OF LABOR
PA186917OtherUNISON
PA25-1716306OtherINTERGROUP
PA25-1716306OtherINFORMED
PA7457237OtherAETNA NON-HMO
PAG920-0059/KV77CUOtherCAREFIRST
PA25-1716306OtherDEVON
PA867633OtherMEDICARE GROUP #
PA25-1716306OtherHEALTHNET/TRICARE
PA440490OtherHEALTH AMERICA
PAMD072147LOtherLICENSE
PA1559303OtherGATEWAY
PA25-1716306OtherSOUTH CENTRAL PREFERRED
PAP00377960OtherRAILROAD MEDICARE
PA2144240OtherMAMSI
PA25-1716306OtherFIRST HEALTH
PA50060635OtherCAPITAL BLUECROSS
PA928593OtherHIGHMARK BLUESHIELD
PA1007307260034OtherMEDICAID GROUP #
PA1007307260034OtherMEDICAID GROUP #
PA867633OtherMEDICARE GROUP #
PAH48605Medicare UPIN