Provider Demographics
NPI:1063453777
Name:MILIARESIS, CHRISTA LINDA (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTA
Middle Name:LINDA
Last Name:MILIARESIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:CHRISTA
Other - Middle Name:LINDA
Other - Last Name:GROSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:447 HIGH RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-3021
Mailing Address - Country:US
Mailing Address - Phone:203-430-2219
Mailing Address - Fax:203-430-2219
Practice Address - Street 1:19 BRADHURST AVE
Practice Address - Street 2:DEPARTMENT OF PEDIATRIC CARDIOLOGY
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2140
Practice Address - Country:US
Practice Address - Phone:914-594-4370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT044419208000000X, 2080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics