Provider Demographics
NPI:1861217283
Name:D'AMBRO, CHRISTINA (PT, DPT)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:D'AMBRO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 NEW HARTFORD SHOPPING CTR
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-1618
Mailing Address - Country:US
Mailing Address - Phone:315-793-1878
Mailing Address - Fax:315-793-1868
Practice Address - Street 1:104 NEW HARTFORD SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-1618
Practice Address - Country:US
Practice Address - Phone:315-793-1878
Practice Address - Fax:315-793-1868
Is Sole Proprietor?:No
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051156-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist