Provider Demographics
NPI:1669787024
Name:SYMULA, CHRISTINE JEANNE (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:JEANNE
Last Name:SYMULA
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:MRS
Other - First Name:CHRISTINE
Other - Middle Name:JEANNE
Other - Last Name:SYMULA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:PO BOX 81
Mailing Address - Street 2:
Mailing Address - City:REMSEN
Mailing Address - State:NY
Mailing Address - Zip Code:13438-0081
Mailing Address - Country:US
Mailing Address - Phone:315-794-4362
Mailing Address - Fax:
Practice Address - Street 1:10551 STEUBEN STREET
Practice Address - Street 2:
Practice Address - City:REMSEN
Practice Address - State:NY
Practice Address - Zip Code:13438-0081
Practice Address - Country:US
Practice Address - Phone:315-794-4362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003357-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics