Provider Demographics
NPI:1225594856
Name:CHRISTIAN JOHN INC
Entity Type:Organization
Organization Name:CHRISTIAN JOHN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSSEF
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:347-962-5207
Mailing Address - Street 1:75A LAKE RD STE 155
Mailing Address - Street 2:
Mailing Address - City:CONGERS
Mailing Address - State:NY
Mailing Address - Zip Code:10920-2323
Mailing Address - Country:US
Mailing Address - Phone:845-589-0800
Mailing Address - Fax:
Practice Address - Street 1:4 MARTINE AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-4016
Practice Address - Country:US
Practice Address - Phone:347-962-5207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty