Provider Demographics
NPI:1174512271
Name:VYSKOCIL, CHRISTINE R (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:R
Last Name:VYSKOCIL
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:2700 WESTCHESTER AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PURCHASE
Mailing Address - State:NY
Mailing Address - Zip Code:10577-2547
Mailing Address - Country:US
Mailing Address - Phone:914-681-3146
Mailing Address - Fax:914-457-1198
Practice Address - Street 1:170 MAPLE AVE
Practice Address - Street 2:309
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4710
Practice Address - Country:US
Practice Address - Phone:914-949-8338
Practice Address - Fax:914-949-9406
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2013-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY209309-1174400000X
NY209309207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG10324Medicare UPIN
NY2T6471Medicare PIN