Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
N | 224P00000X | Prosthetist |
NPI | 1427151307 |
---|---|
Provider Name | Mr. Blake M. Christoph |
First Address | Jenkintown, PA 19046-1611 |
Second Address | Jenkintown, PA 19046-1611 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0002587000 | KEYSTONE HEALTH PLAN EAST (01) | PA |
0002587000 | PERSONAL CHOICE (01) | PA |
0561550 | (05) | PA |
282753 | PENNSYLVANIA BLUE SHIELD (01) | PA |
3486303 | (05) | NJ |
3910 | AETNA (01) | PA |