Provider Demographics
NPI:1386722635
Name:PROBE, CHRISTINE L (DC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:L
Last Name:PROBE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 MANTUA PIKE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08097-1149
Mailing Address - Country:US
Mailing Address - Phone:856-845-0360
Mailing Address - Fax:856-845-1881
Practice Address - Street 1:740 MANTUA PIKE
Practice Address - Street 2:
Practice Address - City:WOODBURY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08097-1149
Practice Address - Country:US
Practice Address - Phone:856-845-0360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00263400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ455870OtherKEYSTONE IND.
NJ0526304OtherAETNA
NJ1K0384OtherHEALTHNET
NJ621921OtherUNITED HEALTH CARE
NJ6298001Medicaid
NJP833467OtherOXFORD
NJ223343095OtherTAX ID
NJ0105502000OtherAMERIHEALTH
NJ455870CMQMedicare ID - Type UnspecifiedMEDICARE