Healthcare Provider Details

I. General information

NPI: 1740953702
Provider Name (Legal Business Name): CHRISTINA KEYSER AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2021
Last Update Date: 01/31/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 MAIN ST STE 201
PHOENIXVILLE PA
19460-4459
US

IV. Provider business mailing address

826 MAIN ST STE 201
PHOENIXVILLE PA
19460-4459
US

V. Phone/Fax

Practice location:
  • Phone: 106-415-1100
  • Fax: 610-415-1101
Mailing address:
  • Phone: 610-415-1100
  • Fax: 610-415-1101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAT006789
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number41YA00115500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: