Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT017084 | PA |
N | 2251G0304X | Physical Therapist - Geriatrics | ||
N | 2251P0200X | Physical Therapist - Pediatrics | ||
N | 2251S0007X | Physical Therapist - Sports | ||
N | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1144217704 |
---|---|
Provider Name | Christine Marie Siegrist |
First Address | Exeter, PA 18643-1161 |
Second Address | Tamaqua, PA 18252-4431 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2005 |
Last Update Date | 19/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11312146 | CAQH (01) | |
1676334 | HIGHMARK BLUE SHIELD (01) | |
2001143 | KEYSTONE (01) | |
2350844000 | INDEPENDENCE BLUE CROSS (01) | |
257271 | HEALTH ASSURANCE (01) | |
3561767 | AETNA HMO (01) | |
50044276 | CAPITAL BLUE CROSS (01) | |
7610567 | AETNA PPO (01) | |
818896 | FIRST PRIORITY HEALTH (01) | |
P00198354 | RAILROAD MEDICARE (01) | |
Q35094 | (02) |