MEDICARE: MS. CHRISTINE JEAN THOMPSON P.T.

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	013600	NY

General Provider Information

NPI Number	:	1588631519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINE JEAN THOMPSON P.T.

Provider Business Mailing Address
First Line	:	45 LOCKWOOD AVE
Second Line	:
City	:	FARMINGDALE
State	:	NY
Zip	:	11735-4508
Country	:	US
Telephone Number	:	516-694-2534
Fax Number	:	516-694-2534

Provider Business Practice Location Address
First Line	:	1554 NORTHERN BLVD
Second Line	:	FOURTH FLOOR
City	:	MANHASSET
State	:	NY
Zip	:	11030-3006
Country	:	US
Telephone Number	:	516-627-8470
Fax Number	:	516-365-8941

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

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	07/08/2007

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