Healthcare Provider Details

I. General information

NPI: 1255651147
Provider Name (Legal Business Name): CHRISTEEN BAGUILAT SOLANG PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2010
Last Update Date: 12/02/2021
Certification Date: 12/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S CENTRAL AVE
LAUREL DE
19956-1571
US

IV. Provider business mailing address

350 NEW FIDELITY CT
GARNER NC
27529-2665
US

V. Phone/Fax

Practice location:
  • Phone: 302-280-6953
  • Fax: 302-715-5001
Mailing address:
  • Phone: 919-258-2714
  • Fax: 410-648-4878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberJ1-0002663
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: