Provider Demographics
NPI:1689719072
Name:ELLIS, CHRISTINE A (MS, PT)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:ELLIS
Suffix:
Gender:F
Credentials:MS, PT
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:115 MAIN STREER
Mailing Address - Street 2:SUITE 202 2ND FLOOR
Mailing Address - City:TUCKAHOE
Mailing Address - State:NY
Mailing Address - Zip Code:10707-2948
Mailing Address - Country:US
Mailing Address - Phone:914-961-1010
Mailing Address - Fax:914-961-1011
Practice Address - Street 1:115 MAIN ST
Practice Address - Street 2:SUITE 202 2ND FLOOR
Practice Address - City:TUCKAHOE
Practice Address - State:NY
Practice Address - Zip Code:10707-2948
Practice Address - Country:US
Practice Address - Phone:914-961-1010
Practice Address - Fax:914-961-1011
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2014-12-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY016671225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0131296OtherAMERIGROUP- HEALTHY1ST MEDICAID, NY MEDICARE BALANCE, NY MEDICARE SPECIALITY
NY03282455Medicaid
NY818164OtherOPTUM PHYSICAL THERAPY OXFORD-CHILD HLTH PLUS,FAMILY HLTH,OXFORD LIBERTY
NY0401997OtherAETNA ORTHONET MCLEAN AVENUE
NY2689719072-01OtherHHC CHOICES GOLD HEALTH PLAN
NYIN NETWORKOtherAGEWELL
NY0401995OtherUS FAMILY -ORTHONET TUCKAHOE
NY201116700038OtherAFFINITY HEALTH PLAN
NY272438120OtherVNS-NYS
NY272438120OtherAGEWELL
NY272438129-001OtherHEALTH 1ST, HEALTH1ST MEDICARE, HEALTH1ST COMPLETECARE, HEALTH1ST COMMERCIAL
NY703204OtherMPN NY STATE- OPTUM PHYSICAL THERAPY
NY786980OtherOPTUM PHYSICAL THERAPY UHC (FACILITY)
NYACS-616130500OtherFECA/OFFICE OF WORKERS COMPENSATION PROGRAMS
NYIN NETWORKOtherMAGNACARE ADMINISTRSTIVE SERVICES, LLC
NYQN7941OtherEMPIRE BLUE CROSS
NY0401997OtherCIGNA ORTHONET MCLEAN AVENUE
NY7964370OtherAETNA LOCAL 1199
1251OtherAMIDACARE-GROUP
NY272438120OtherFNP MULTIPLAN
NY272438120OtherPOMCO
NY786980OtherOPTUM PHYSICAL THERAPY EVERCARE (FACILITY)
NYP00970479OtherMVP HEALTH PLAN
NY272438120OtherHUDSON HEALTH PLAN -CHILD PLUS MEDICAID, FAMILY PLUS MEDICAID
NY786980OtherOPTUM PHYSICAL THERAPY (FACILITY)
NY818164OtherORANGE/ULSTER COUNTY-OPTUM PHYSICAL THERAPY
NYIN NETWORKOtherOPTUM HEALTHCARE SOLUTIONS-PT
NY0401995OtherAETNA ORTHONET-TUCKAHOE
NY0401995OtherCIGNA ORTHONET TUCKAHOE
NY0401997OtherUS FAMILY ORTHONET MCLEAN AVENUE
NY2343974OtherHUMANA
NYQN7941OtherEMPIRE BLUE CROSS