Provider Demographics
NPI:1508361353
Name:PATRONE, CHRISTINA CHUNG (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:CHUNG
Last Name:PATRONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 GROVE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1752
Mailing Address - Country:US
Mailing Address - Phone:856-853-0900
Mailing Address - Fax:
Practice Address - Street 1:500 GROVE ST STE 200
Practice Address - Street 2:
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1752
Practice Address - Country:US
Practice Address - Phone:856-853-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY318465-01207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program