Provider Demographics
NPI:1407623556
Name:PAHANISH, CHRISTINA JOANNE
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:JOANNE
Last Name:PAHANISH
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 1:2712 MAXINE AVE NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44705-3662
Mailing Address - Country:US
Mailing Address - Phone:234-360-4524
Mailing Address - Fax:
Practice Address - Street 1:2712 MAXINE AVE NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44705-3662
Practice Address - Country:US
Practice Address - Phone:234-360-4524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide