Provider Demographics
NPI:1992777197
Name:BARTOLETTI, CHRISTINE M (OD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:BARTOLETTI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:M
Other - Last Name:TRUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2003 S ROLLING ROCK PL
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-5159
Mailing Address - Country:US
Mailing Address - Phone:520-403-3669
Mailing Address - Fax:
Practice Address - Street 1:560 E CONTINENTAL RD STE 104
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-1825
Practice Address - Country:US
Practice Address - Phone:520-625-5673
Practice Address - Fax:520-625-6259
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ00976152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ448680Medicaid
AZU70694Medicare UPIN
AZZ115448Medicare PIN