Healthcare Provider Details

I. General information

NPI: 1992497945
Provider Name (Legal Business Name): CHRISTOPHER TINTI PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CHRISTOPHER EDWARD TINTI PT, DPT

II. Dates (important events)

Enumeration Date: 05/25/2023
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 W MAIN ST
PATCHOGUE NY
11772-3008
US

IV. Provider business mailing address

18 LOVERS LN
MEDFORD NY
11763-4081
US

V. Phone/Fax

Practice location:
  • Phone: 631-228-4977
  • Fax:
Mailing address:
  • Phone: 631-804-7640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number050379-01
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: