Provider Demographics
NPI:1154322584
Name:MOSSE, CHRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:MOSSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 E 72ND ST
Mailing Address - Street 2:NO 33D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4671
Mailing Address - Country:US
Mailing Address - Phone:212-734-2573
Mailing Address - Fax:212-628-7312
Practice Address - Street 1:2336 2ND AVE
Practice Address - Street 2:SECOND AVENUE PHYSICIAN PRACTICE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-4219
Practice Address - Country:US
Practice Address - Phone:212-987-5200
Practice Address - Fax:212-987-5210
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215675207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine