Provider Demographics
NPI:1235116815
Name:LAY, CHRISTINE L (MD, FRCPC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:L
Last Name:LAY
Suffix:
Gender:F
Credentials:MD, FRCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 95000-2392
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-2392
Mailing Address - Country:US
Mailing Address - Phone:212-523-7621
Mailing Address - Fax:212-523-7494
Practice Address - Street 1:1000 10TH AVE
Practice Address - Street 2:SUITE 1C10
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1147
Practice Address - Country:US
Practice Address - Phone:212-523-5869
Practice Address - Fax:212-523-7494
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0011202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF92181Medicare UPIN
NY4Y4161Medicare ID - Type Unspecified