Provider Demographics
NPI:1790821437
Name:DE LOS SANTOS, CHRISTOPHER (DPT)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:DE LOS SANTOS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 JEFFERSON ST
Mailing Address - Street 2:UNIT 4
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-2012
Mailing Address - Country:US
Mailing Address - Phone:201-543-7022
Mailing Address - Fax:
Practice Address - Street 1:527 JEFFERSON ST
Practice Address - Street 2:UNIT 4
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-2012
Practice Address - Country:US
Practice Address - Phone:201-543-7022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01166600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist