Provider Demographics
NPI:1124869391
Name:WITMER, CHRISTINA (BA)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:WITMER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1528 WALNUT ST STE 805
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-3608
Mailing Address - Country:US
Mailing Address - Phone:267-478-7001
Mailing Address - Fax:
Practice Address - Street 1:1528 WALNUT ST STE 805
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-3608
Practice Address - Country:US
Practice Address - Phone:267-478-7001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program