Provider Demographics
NPI:1336111863
Name:CHESNA, CHRISTINE M (PT)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:M
Last Name:CHESNA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 BETHANY TPKE
Mailing Address - Street 2:
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18431-4044
Mailing Address - Country:US
Mailing Address - Phone:570-251-7849
Mailing Address - Fax:
Practice Address - Street 1:354 MAIN ST
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:PA
Practice Address - Zip Code:18421-1418
Practice Address - Country:US
Practice Address - Phone:570-785-2018
Practice Address - Fax:570-785-3575
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013474L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA106714RHKMedicare PIN