Christopher James Mammola, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

TEI002589 Issued in PA

Practice address

1413 W. Moyamensing Ave.
Philadelphia, PA 19145

Phone

(215) 639-2555

NPI assigned

Mar 15, 2010

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1417271818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 HIGHLAND AVE,",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "08077",
            "telephone_number": "856-361-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 W. MOYAMENSING AVE.",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19145",
            "telephone_number": "215-639-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMMOLA",
        "first_name": "CHRISTOPHER",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-15",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TEI002589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Anne Mamienski, CRNP
• Ajit Mammen, M.B.B.S.
• Evelyn Mammen
• Mirium Mammen, DO
• Priya Elizabeth Mammen, MD
• Sarah Mammon
• Alexandra Mamolou, LPC
• Julianne Mamrol
• Mira Mamtani, MD
• Raashi Mamtani, DO

• Physical Therapy Assistant in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Physical Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.