Provider Demographics
NPI:1255688412
Name:PIKE, CHRISTINE ANN (MSED)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANN
Last Name:PIKE
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 BLOOMINGROVE DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-8404
Mailing Address - Country:US
Mailing Address - Phone:518-283-4921
Mailing Address - Fax:518-687-0375
Practice Address - Street 1:127 BLOOMINGROVE DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-8404
Practice Address - Country:US
Practice Address - Phone:518-283-4921
Practice Address - Fax:518-687-0375
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist