Provider Demographics
NPI:1326284977
Name:TRABA, CHRISTIN M (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:M
Last Name:TRABA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTIN
Other - Middle Name:M
Other - Last Name:MORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:15 ZABRISKIE AVE APT 2C
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-7302
Mailing Address - Country:US
Mailing Address - Phone:201-388-3537
Mailing Address - Fax:
Practice Address - Street 1:150 BERGEN ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2496
Practice Address - Country:US
Practice Address - Phone:973-972-5632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-05
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08590000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics