Individual
MRS. CHRISTINA MARIE PERSONIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
4094
MA
152W00000X
Optometrist
Primary
OEG000707
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
217381
COLE
—
01
—
2927764
AETNA
PA
01
—
P00080142
RAILROAD MEDICARE
PA
01
—
PA0707
EYE MED
PA
01
—
PE 1313911
BC BS
PA
Enumeration date
02/07/2006
Last updated
09/27/2007
Update your record
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