Provider Demographics
NPI:1437411923
Name:ADAMS, CHRISTINE
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:ADAMS
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 1:680 COUNTY ROUTE 18
Mailing Address - Street 2:
Mailing Address - City:LAKE CLEAR
Mailing Address - State:NY
Mailing Address - Zip Code:12945-1813
Mailing Address - Country:US
Mailing Address - Phone:518-891-4367
Mailing Address - Fax:
Practice Address - Street 1:680 COUNTY ROUTE 18
Practice Address - Street 2:
Practice Address - City:LAKE CLEAR
Practice Address - State:NY
Practice Address - Zip Code:12945-1813
Practice Address - Country:US
Practice Address - Phone:518-891-4367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist