Provider Demographics
NPI:1730249939
Name:OLIVEIRA, CHRISTOPHER JAMES (PT)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:OLIVEIRA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 HILL ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3192
Mailing Address - Country:US
Mailing Address - Phone:203-882-9384
Mailing Address - Fax:203-882-9385
Practice Address - Street 1:155 HILL ST
Practice Address - Street 2:SUITE B
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3192
Practice Address - Country:US
Practice Address - Phone:203-882-9384
Practice Address - Fax:203-882-9385
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7509225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT650001050Medicare ID - Type UnspecifiedMEDICARE NUMBER