Provider Demographics
NPI:1285773168
Name:SANTA MARIA, CHRISTINA LYNNE (MSPT)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LYNNE
Last Name:SANTA MARIA
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 PUTNAM CT
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-4014
Mailing Address - Country:US
Mailing Address - Phone:631-462-2716
Mailing Address - Fax:
Practice Address - Street 1:12 PUTNAM CT
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-4014
Practice Address - Country:US
Practice Address - Phone:631-462-2716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0219432251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics