MEDICARE: CHRISTOPHER ANDRADA MILLAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	40QA01442800	NJ

General Provider Information

NPI Number	:	1861896359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER ANDRADA MILLAN

Provider Business Mailing Address
First Line	:	277 KENNEDY BLVD
Second Line	:
City	:	BAYONNE
State	:	NJ
Zip	:	07002-1212
Country	:	US
Telephone Number	:	201-688-9702
Fax Number	:

Provider Business Practice Location Address
First Line	:	438B W SIDE AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07304-1426
Country	:	US
Telephone Number	:	201-374-1930
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2014
Last Update Date	:	04/16/2021

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Directions to “ CHRISTOPHER ANDRADA MILLAN ” Practice Location

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