Healthcare Provider Details

I. General information

NPI: 1639115751
Provider Name (Legal Business Name): CHRISTINE H BECK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 CORPORATE DR SUITE #6
EASTON PA
18045-2664
US

IV. Provider business mailing address

21 CORPORATE DR SUITE #6
EASTON PA
18045-2664
US

V. Phone/Fax

Practice location:
  • Phone: 610-250-9666
  • Fax: 610-250-9606
Mailing address:
  • Phone: 610-250-9666
  • Fax: 610-250-9606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License NumberMD026690E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: