Provider Demographics
NPI:1770892234
Name:MCCAFFREY, CHRISTINE (PT)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:MCCAFFREY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 HILL TER
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5304
Mailing Address - Country:US
Mailing Address - Phone:732-576-8168
Mailing Address - Fax:
Practice Address - Street 1:40 MERRILL AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3312
Practice Address - Country:US
Practice Address - Phone:718-370-7529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012522-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics