Provider Demographics
NPI:1770608887
Name:FISTLER, CHRISTA R (MD)
Entity type:Individual
Prefix:
First Name:CHRISTA
Middle Name:R
Last Name:FISTLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTA
Other - Middle Name:REBECCA
Other - Last Name:TOKARSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:200 HYGEIA DRIVE
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2049
Mailing Address - Country:US
Mailing Address - Phone:302-623-7362
Mailing Address - Fax:
Practice Address - Street 1:4745 OGLETOWN STANTON ROAD
Practice Address - Street 2:MAP 1, SUITE 220
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2074
Practice Address - Country:US
Practice Address - Phone:302-368-5515
Practice Address - Fax:302-266-6169
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
DEC1-0010029207RP1001X
MDD65421207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine