Provider Demographics
NPI:1053680413
Name:POSSEMATO, CHRISTINE R (NP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:R
Last Name:POSSEMATO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:422 MORRIS AVE
Mailing Address - Street 2:STE 7
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-6574
Mailing Address - Country:US
Mailing Address - Phone:908-670-2892
Mailing Address - Fax:732-443-4884
Practice Address - Street 1:422 MORRIS AVE
Practice Address - Street 2:STE 7
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-6574
Practice Address - Country:US
Practice Address - Phone:908-670-2892
Practice Address - Fax:732-443-4884
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00383500363LP0808X
NY40401445363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health