Provider Demographics
NPI:1164583571
Name:CARRON, CHRISTINE E (NP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:E
Last Name:CARRON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6255 SHERIDAN DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4836
Mailing Address - Country:US
Mailing Address - Phone:716-857-8666
Mailing Address - Fax:716-630-1054
Practice Address - Street 1:3345 SOUTHWESTERN BLVD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1506
Practice Address - Country:US
Practice Address - Phone:716-656-4825
Practice Address - Fax:716-250-5944
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY331320363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS59407Medicare UPIN
NY00026509901OtherUNIVERA
NY9511896OtherIHA
NYRA6851Medicare ID - Type Unspecified
NY000560198004OtherCB BCBS