Provider Demographics
NPI:1144205006
Name:DUFFY, CHRISTINA MARIE
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:DUFFY
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 1:5443 LEMAY AVE
Mailing Address - Street 2:
Mailing Address - City:BUZZARDS BAY
Mailing Address - State:MA
Mailing Address - Zip Code:02542-1556
Mailing Address - Country:US
Mailing Address - Phone:508-564-4962
Mailing Address - Fax:
Practice Address - Street 1:5201 LEE RD
Practice Address - Street 2:
Practice Address - City:BUZZARDS BAY
Practice Address - State:MA
Practice Address - Zip Code:02542-1313
Practice Address - Country:US
Practice Address - Phone:508-968-6702
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider