Provider Demographics
NPI:1346698347
Name:PAUL, CHRISTINA
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:PAUL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 SHUART RD
Mailing Address - Street 2:
Mailing Address - City:AIRMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10952-4734
Mailing Address - Country:US
Mailing Address - Phone:845-323-9868
Mailing Address - Fax:
Practice Address - Street 1:120 N MAIN ST
Practice Address - Street 2:SUITE 207
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3717
Practice Address - Country:US
Practice Address - Phone:845-638-3072
Practice Address - Fax:845-638-3073
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator