Provider Demographics
NPI:1124337738
Name:MALINAUSKAS, CHRISTINE MARTHA (PT)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MARTHA
Last Name:MALINAUSKAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:122 LOUIS ST
Mailing Address - Street 2:
Mailing Address - City:N MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-1404
Mailing Address - Country:US
Mailing Address - Phone:516-293-2358
Mailing Address - Fax:516-293-2358
Practice Address - Street 1:122 LOUIS ST
Practice Address - Street 2:
Practice Address - City:N MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-1404
Practice Address - Country:US
Practice Address - Phone:516-293-2358
Practice Address - Fax:516-293-2358
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020111-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist