Provider Demographics
NPI:1518933282
Name:CHEW, CHRISTINE M (PHD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:M
Last Name:CHEW
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 SILAS DEANE HWY
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4337
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:275 MOUNT CARMEL AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-1908
Practice Address - Country:US
Practice Address - Phone:203-407-4020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301013799103T00000X
PAPS009147L103T00000X
CT003973103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI680B516180OtherBCBSM PIN
MI680B510920OtherBCBSM GROUP
PA001888385Medicaid
PA055369Medicare ID - Type Unspecified
MIM54870018Medicare PIN
MI680B516180OtherBCBSM PIN