Provider Demographics
NPI:1205190394
Name:ROSEN, CHRISTINA M
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:M
Last Name:ROSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 HUNTER RIDGE RD N
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-2706
Mailing Address - Country:US
Mailing Address - Phone:516-503-2022
Mailing Address - Fax:
Practice Address - Street 1:129 HUNTER RIDGE RD N
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-2706
Practice Address - Country:US
Practice Address - Phone:516-503-2022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist