Individual
CHRISTA DIJSTELBERGEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
314 S MANNING BLVD, ALBANY, NY 12208-1708
(518) 453-2273
Mailing address
314 S MANNING BLVD, ALBANY, NY 12208-1708
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
020772
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00020772
—
NY
01
—
10096396
CDPHP
—
Enumeration date
06/02/2006
Last updated
07/08/2007
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