Provider Demographics
NPI:1184661563
Name:MONAHAN, CHRISTINE ELIZABETH (RN)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:ELIZABETH
Last Name:MONAHAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:ELIZABETH
Other - Last Name:SANEWSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:24 KURT RD
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-3957
Mailing Address - Country:US
Mailing Address - Phone:585-314-1206
Mailing Address - Fax:
Practice Address - Street 1:115 SULLYS TRL STE 13
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-4571
Practice Address - Country:US
Practice Address - Phone:585-385-0560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2014-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9184111N00000X
NY639100163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U75745Medicare UPIN
NYRA9719Medicare ID - Type Unspecified