Provider Demographics
NPI:1457390189
Name:CHRISTOPHE, KATHLEEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:M
Last Name:CHRISTOPHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5045 US-130
Mailing Address - Street 2:
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-2908
Mailing Address - Country:US
Mailing Address - Phone:856-764-7660
Mailing Address - Fax:856-764-5723
Practice Address - Street 1:5045 US-130
Practice Address - Street 2:
Practice Address - City:DELRAN
Practice Address - State:NJ
Practice Address - Zip Code:08075-2908
Practice Address - Country:US
Practice Address - Phone:856-764-7660
Practice Address - Fax:856-764-5723
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD421558207V00000X
NJ25MA09044500207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0452238Medicaid
PA597586OtherMEDICARE GROUP TPI
PA100849394Medicaid
PACD4829OtherRAILROAD MEDICARE TPI GROUP
PA075049Medicare ID - Type Unspecified