Provider Demographics
NPI:1386144483
Name:FAUST, CHISTOPHER
Entity type:Individual
Prefix:
First Name:CHISTOPHER
Middle Name:
Last Name:FAUST
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 COMMERCE WAY STE 120
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-8200
Mailing Address - Country:US
Mailing Address - Phone:603-427-8066
Mailing Address - Fax:603-501-0495
Practice Address - Street 1:6 FORTUNE DR
Practice Address - Street 2:
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-3917
Practice Address - Country:US
Practice Address - Phone:978-408-2000
Practice Address - Fax:978-408-2019
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23458225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist