Provider Demographics
NPI:1750364840
Name:WARTHLING, CHRISTA R (RPAC)
Entity type:Individual
Prefix:
First Name:CHRISTA
Middle Name:R
Last Name:WARTHLING
Suffix:
Gender:F
Credentials:RPAC
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Mailing Address - Street 1:908 NIAGARA FALLS BLVD
Mailing Address - Street 2:STE 208
Mailing Address - City:N TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2019
Mailing Address - Country:US
Mailing Address - Phone:716-692-2160
Mailing Address - Fax:716-692-4342
Practice Address - Street 1:415 TREMONT ST
Practice Address - Street 2:
Practice Address - City:N TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-6135
Practice Address - Country:US
Practice Address - Phone:716-690-2001
Practice Address - Fax:716-692-4342
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2008-04-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY010668363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00057054601OtherBLUE CROSS/COMM BLUE
NY00027238201OtherUNIVERA
NY00027238201OtherUNIVERA