Provider Demographics
NPI:1225539307
Name:BRAREN, CHRISTOPHER EDWARD (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:EDWARD
Last Name:BRAREN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 E 57TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-6010
Mailing Address - Country:US
Mailing Address - Phone:718-451-5213
Mailing Address - Fax:
Practice Address - Street 1:475 E 57TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-6010
Practice Address - Country:US
Practice Address - Phone:718-451-5213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY669640-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYSE19399ZMedicaid