Provider Demographics
NPI:1952422206
Name:MCCAULEY, CHRISTINE MARGARET (MPT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MARGARET
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5210 NEW PROSPECT CT
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-6679
Mailing Address - Country:US
Mailing Address - Phone:410-461-1506
Mailing Address - Fax:
Practice Address - Street 1:8165 CYPRUS CEDAR LN
Practice Address - Street 2:STE 205
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-5565
Practice Address - Country:US
Practice Address - Phone:410-799-0818
Practice Address - Fax:410-799-2653
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD194402251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD981L588EMedicare ID - Type UnspecifiedPROVIDER NUMBER