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NPI Code Detail

MEDICARE: CHRISTINE M. FREDERICKS P.T.

MEDICARE: CHRISTINE M. FREDERICKS 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
1225100000XPhysical TherapistPT006642LPA

General Provider Information

NPI Number : 1720103302
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE M. FREDERICKS P.T.
Provider Business Mailing Address
First Line : 261 THUNDER CIR
Second Line :
City : BENSALEM
State : PA
Zip : 19020-2157
Country : US
Telephone Number : 215-741-3135
Fax Number :
Provider Business Practice Location Address
First Line : 10400 ROOSEVELT BLVD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19116-3905
Country : US
Telephone Number : 215-698-5686
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 07/08/2007

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