Provider Demographics
NPI:1730221086
Name:KUSHNER, CHRISTINE SHEILA (PT)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:SHEILA
Last Name:KUSHNER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:S
Other - Last Name:MAGALLANES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2000 S GLENBURNIE RD STE 210
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-5227
Mailing Address - Country:US
Mailing Address - Phone:252-302-5200
Mailing Address - Fax:
Practice Address - Street 1:2000 S GLENBURNIE RD STE 210
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5227
Practice Address - Country:US
Practice Address - Phone:252-302-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070006639225100000X
NCP21570225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist