Provider Demographics
NPI:1982700506
Name:HERSKOWITZ, CHRISTIANE (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTIANE
Middle Name:
Last Name:HERSKOWITZ
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 1:37 TALCOTT RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-2094
Mailing Address - Country:US
Mailing Address - Phone:802-881-5698
Mailing Address - Fax:888-406-8044
Practice Address - Street 1:8031 WILLISTON RD STE 6
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-6200
Practice Address - Country:US
Practice Address - Phone:802-881-5698
Practice Address - Fax:888-406-8044
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040-0002823225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist