Provider Demographics
NPI:1871168310
Name:MOONEY, CHRISTOPHER JOHN
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:MOONEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 REEVE AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07403-1500
Mailing Address - Country:US
Mailing Address - Phone:908-868-4000
Mailing Address - Fax:
Practice Address - Street 1:2 ARROWHEAD TRL
Practice Address - Street 2:
Practice Address - City:KINNELON
Practice Address - State:NJ
Practice Address - Zip Code:07405-3102
Practice Address - Country:US
Practice Address - Phone:973-838-8883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00116900225X00000X, 225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist