Provider Demographics
NPI:1992778070
Name:KAMME, CHRISTINA MARIA (PT)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARIA
Last Name:KAMME
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 1:200 BOUNDARY AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-1152
Mailing Address - Country:US
Mailing Address - Phone:516-249-3760
Mailing Address - Fax:516-249-4970
Practice Address - Street 1:200 BOUNDARY AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-1152
Practice Address - Country:US
Practice Address - Phone:516-249-3760
Practice Address - Fax:516-249-4970
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0254381225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ09C3QC201Medicare PIN
NYQ09C31Medicare UPIN