Provider Demographics
NPI:1023596517
Name:MORINI, CHRISTIAN (DPT)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:MORINI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 SCANTIC DR
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-3042
Mailing Address - Country:US
Mailing Address - Phone:860-253-5196
Mailing Address - Fax:860-253-5197
Practice Address - Street 1:113 ELM ST STE 201
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-3739
Practice Address - Country:US
Practice Address - Phone:860-253-5196
Practice Address - Fax:860-253-5197
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11936225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist