Provider Demographics
NPI:1174785349
Name:CHRISTMAN, HEATHER C
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:C
Last Name:CHRISTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 GARNER ST APT 2S
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-2542
Mailing Address - Country:US
Mailing Address - Phone:518-265-1992
Mailing Address - Fax:
Practice Address - Street 1:120 WASHINGTON AVENUE EXT
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-5367
Practice Address - Country:US
Practice Address - Phone:518-456-4151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008858-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician