Provider Demographics
NPI:1164813770
Name:MACH, CHRISTINA J (APN)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:J
Last Name:MACH
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1A REGULUS DRIVE
Mailing Address - Street 2:
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012
Mailing Address - Country:US
Mailing Address - Phone:844-542-2273
Mailing Address - Fax:856-256-7518
Practice Address - Street 1:1A REGULUS DRIVE
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012
Practice Address - Country:US
Practice Address - Phone:844-542-2273
Practice Address - Fax:856-256-7518
Is Sole Proprietor?:No
Enumeration Date:2015-02-18
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR13123200363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ436455ZGH1Medicare PIN