Provider Demographics
NPI:1588775233
Name:CASAREZ, CHRISTINA M (OT)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:CASAREZ
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 PALOMINO LN
Mailing Address - Street 2:STE 401
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6447
Mailing Address - Country:US
Mailing Address - Phone:603-669-7716
Mailing Address - Fax:603-669-0103
Practice Address - Street 1:80 PALOMINO LN
Practice Address - Street 2:STE 401
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6447
Practice Address - Country:US
Practice Address - Phone:603-669-7716
Practice Address - Fax:603-669-0103
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1443225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH020434629OtherTAX ID
NHAA17751OtherHARVARD ID
NH597569OtherAETNA ID
NH30412010Medicaid
NH54201OtherCIGNA ID
NH13YOO3474NH01OtherANTHEM ID