Provider Demographics
NPI:1437327061
Name:ABRUZZO, CHRISTINE LYNN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:LYNN
Last Name:ABRUZZO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CROCUS LN
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-3628
Mailing Address - Country:US
Mailing Address - Phone:631-423-6380
Mailing Address - Fax:631-351-1560
Practice Address - Street 1:683 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-4613
Practice Address - Country:US
Practice Address - Phone:631-423-6380
Practice Address - Fax:631-351-1560
Is Sole Proprietor?:No
Enumeration Date:2008-02-17
Last Update Date:2008-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045471183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY045471OtherNYS LIC. #