Provider Demographics
NPI:1033976212
Name:GEORGE-ALEXIS, CHRISTINE JILLIEAN
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:JILLIEAN
Last Name:GEORGE-ALEXIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21924 109TH AVE
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11429-2504
Mailing Address - Country:US
Mailing Address - Phone:347-834-2852
Mailing Address - Fax:
Practice Address - Street 1:21924 109TH AVE
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11429-2504
Practice Address - Country:US
Practice Address - Phone:347-834-2852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty