Provider Demographics
NPI:1194004226
Name:BOKHOUR, CHRISTINE (LAC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:BOKHOUR
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 RIVERSIDE DR # 2A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1007
Mailing Address - Country:US
Mailing Address - Phone:917-340-8449
Mailing Address - Fax:
Practice Address - Street 1:123 W 79TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6480
Practice Address - Country:US
Practice Address - Phone:917-340-8449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-07
Last Update Date:2011-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004603-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist