Provider Demographics
NPI:1033467576
Name:DOUKAS, CRISTINA EMMA (LPN)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:EMMA
Last Name:DOUKAS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3626 KINGS HWY
Mailing Address - Street 2:APT. 6J
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-2748
Mailing Address - Country:US
Mailing Address - Phone:347-893-9955
Mailing Address - Fax:
Practice Address - Street 1:3626 KINGS HWY
Practice Address - Street 2:APT.6J
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-2748
Practice Address - Country:US
Practice Address - Phone:347-893-9955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10 310817164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse