Provider Demographics
NPI:1932522521
Name:PETRE, CRISTIAN (MSPT)
Entity Type:Individual
Prefix:
First Name:CRISTIAN
Middle Name:
Last Name:PETRE
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 VINCENT AVE
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-4023
Mailing Address - Country:US
Mailing Address - Phone:203-569-4954
Mailing Address - Fax:
Practice Address - Street 1:37 VINCENT AVE
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-4023
Practice Address - Country:US
Practice Address - Phone:203-569-4954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-02
Last Update Date:2014-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007809225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist