Provider Demographics
NPI:1144386798
Name:PANSARASA, CHRISTINA (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:PANSARASA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:984 HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-5913
Mailing Address - Country:US
Mailing Address - Phone:914-962-8772
Mailing Address - Fax:914-243-7916
Practice Address - Street 1:880 S LAKE BLVD
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-4771
Practice Address - Country:US
Practice Address - Phone:914-962-8772
Practice Address - Fax:914-243-7916
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013034-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY142239OtherVALUEOPTIONS, INC.
NY6888317002OtherGHI
NY196607OtherMHN
NYP2144259OtherOXFORD BEHAVIORAL HEALTH
NY142239OtherVALUEOPTIONS, INC.