Basic Information
| Provider Information | |||||||||
| NPI: | 1255651147 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SOLANG | ||||||||
| FirstName: | CHRISTEEN | ||||||||
| MiddleName: | BAGUILAT | ||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 350 NEW FIDELITY CT | ||||||||
| Address2: | |||||||||
| City: | GARNER | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275292665 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192582714 | ||||||||
| FaxNumber: | 4106484878 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 S CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | LAUREL | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199561571 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3022806953 | ||||||||
| FaxNumber: | 3027155001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2010 | ||||||||
| LastUpdateDate: | 12/02/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | J1-0002663 | DE | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 80003642 | 01 | DE | AMERIHEALTH & KEYSTONE VIP | OTHER | 1255651147 | 05 | DE | MEDICAID | AC44-0053 | 01 | DE | CAREFIRST | OTHER | P01111295 | 01 | DE | RAILROAD MEDICARE | OTHER | 2566859 | 01 | DE | BC BS DE | OTHER | 30096408 | 01 | DE | AMERIHEALTH & KEYSTONE FIRST | OTHER |