Provider Demographics
NPI:1396190740
Name:NAWABI, CHRISTINA FERESHTA (DPM)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:FERESHTA
Last Name:NAWABI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BROOKSITE DR STE 230
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-3492
Mailing Address - Country:US
Mailing Address - Phone:516-606-7784
Mailing Address - Fax:516-506-7123
Practice Address - Street 1:2 BROOKSITE DR STE 230
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3492
Practice Address - Country:US
Practice Address - Phone:516-606-7784
Practice Address - Fax:516-506-7123
Is Sole Proprietor?:No
Enumeration Date:2016-05-03
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN007026213E00000X
NY007026213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist