Provider Demographics
NPI:1477039733
Name:PLAZA, CHRISTIAN JOSE (FNP)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:JOSE
Last Name:PLAZA
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 GIDNEY AVE STE B
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-3741
Mailing Address - Country:US
Mailing Address - Phone:845-561-7075
Mailing Address - Fax:845-561-7006
Practice Address - Street 1:407 GIDNEY AVE STE B
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3741
Practice Address - Country:US
Practice Address - Phone:845-561-7075
Practice Address - Fax:845-561-7006
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF405130363LP0808X
NY343284363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health